Academic literature on the topic 'Appendicitis Alvarado score Ultrasonography Mantrels Appendicectomy'

<strong>Background and Aim:&nbsp;</strong>Alvarado scoring system is one of them and is purely based on history, clinical examination and few laboratory tests and is very easy to apply. Present study was done is to evaluate the role of Alvarado Scoring System (MANTRELS Scoring) in preoperative diagnosis of acute appendicitis.&nbsp;<strong>Material and Methods:</strong>&nbsp;This study was carried out on 100 patients who are having pain in right Iliac Fossa region and these patients were admitted in Department of General Surgery, in our hospital for further evaluation and management. Evaluation of these patients will be done by Alvarado Score and Ultrasonography. Patients were divided in 3 groups: 1) Cases with score of 1-4 were observed and not operated.&nbsp; 2) Cases with score of 5-6 were observed for next 24 hours for revision of scoring. 3) A Patients with score of 7-10 who are considered candidates for appendectomy were assessed again after ultrasonography. The reliability of Alvarado scoring system is assessed by calculating Negative appendicectomy rate and Positive predictive value.&nbsp;<strong>Results:</strong>&nbsp;There were 70 males and 30 females included in the study. The age range of included patients was found to be 8 to 55 years. Out of 100 cases, 14 patients had a score of &lt;5. Out of them, 6 patients seemed to have an inflamed Appendix and 4 patients seemed to have a normal Appendix intraoperatively. On histopathological examination, it was proved that out of these 48 cases, 32 actually had acute appendicitis, 12 patients had chronic appendicitis while the remaining 4 had a normal Appendix.&nbsp;<strong>Conclusion:&nbsp;</strong>Alvarado scoring System is a fast, simple, cost-effective, reliable, non-invasive, repeatable, and safe diagnostic method for acute appendicitis without complications.

Acute appendicitis is not uncommon pathology but clinical diagnosis depends on skills of treating health officer. Now advancement in technology and easy availability of USG and CT scan centers make the easy diagnosis. Some time atypical presentation of acute appendicitis makes delay in diagnosis clinically. But, the modified Alvarado score make easy diagnosis of acute appendicitis and compatible to USG. This is a prospective comparative study conducted at RNT Medical College, Udaipur. This study was done in 50 patients, who were presented with pain right lower abdomen. to compare the sensitivity and specificity of modified Alvarado score and USG in diagnosis of acute appendicitis. there were 28 male and 22 female in this study. Age of Youngest patient in the study was 17 years and elder most was 57 years old. Anorexia was common symptoms after pain at right iliac fossa. Appendicectomy was done in 48 cases (96%) and taw cases were managed conservative. There were 34 (68%) patients who had modified Alvarado score more than 7. Modified Alvarado Score is a simple, practical and quick tool in securing diagnosis of acute appendicitis when score is &amp;#62;7. Its results are similar to USG finding. It also helps to reduce the rate of negative appendicectomy. This study recommend appendicectomy in patients presenting with right iliac fossa pain in whom modified Alvarado score is 7 or more.

Background: Acute appendicitis is the most common cause of an ‘acute abdomen’ in young adults and, as such, the associated symptoms and signs have become a paradigm for clinical teaching. Appendicitis is sufficiently common that appendicectomy (termed appendectomy in North America) is the most frequently performed urgent abdominal operation and is often the first major procedure performed by a surgeon in training. In this study we correlate the usefulness of Modified Alvarado scoring system(MASS) and ultrasonography(USG) in management of acute appendicitis.Methods: The study was done on 60 patients of symptomatic appendicitis, requiring management accordingly, attending surgical OPD of People’s College of Medical Sciences(PCMS) and Research Centre, Bhopal, India from 1st October 2011 to 30th August 2013. The study includes 60 patients between 5-60 yrs of age. They were prospectively evaluated on admission using the modified Alvarado Score to determine whether or not they had acute appendicitis, all equivocal cases were subjected to ultrasonography examination. The score and ultrasonography were correlated with the operative and histological findings.Results: All 60 patients underwent surgery. The sensitivity of the modified Alvarado score was 89.65% and sensitivity of USG was 91.37%, out of 60 cases of acute appendicitis male were 36 and remaining 24 cases were female. So, it showed sex ratio of 36:24, 3:2 which correlate with literature and other studies. With use of both MASS and USG as diagnostic tool, out of 60 cases 57 cases were positive and with the help of histopathology, it was confirmed in 58 cases.Conclusions: The modified Alvarado scoring system is a good diagnostic indicator for acute appendicitis. It helps in minimizing the rates of negative appendicectomy. It can be used as an adjunct to surgical decision-making along with ultrasonography in doubtful cases. When combined, modified Alvarado score and ultrasonography can work very effectively in diagnosing acute appendicitis(AA) correctly and in reducing the number of negative appendicectomy.

Abstract Background: Acute appendicitis is one of the commonest surgical emergencies. Despite a life time cumulative risk of nearly 7% its diagnosis remains a challenge. The risks of two primary outcomes must be balanced in the management of presumed appendicitis: perforation and misdiagnosis.The rate of misdiagnosis in certain populations is as high as 40%. Diagnostic aids like modified Alvarado score and ultrasonography can dramatically reduce the negative appendicectomies. Methods:Data was collected from 60 patients with complains of right iliac fossa pain over a period of 9 months to our hospital. All patients were categorised using the Alvarado score and Graded compression ultrasonography was done. The preoperative and histological findings were compared with the preoperative diagnosis. The collected data was analysed with regards to various parameters like sensitivity, specificity, predictive values and diagnostic accuracy. Results:In our study of 60 patients, 56 patients underwent appendicectomy out of which a histological confirmation of appendicitis was obtained for 50 patients, giving a negative appendicectomy rate of 12%.By taking a cut-off point of 7 for the Modified Alvarado score, a sensitivity of 97.56%, specificity of 66.67%, positive predictive value (PPV) of 95.23%, negative predictive value (NPV) of 80% and accuracy of 87.2% were calculated. Using the cut-off point of 6, a sensitivity of 90% specificity of 50%, PPV of 69.23%, NPV of 80% and accuracy of 55.56% were obtained. The sensitivity, specificity, PPV, NPV and accuracy rate of ultrasonography was 92.15%, 88.9%, 97.19%, 66.7% and 85%, respectively. Conclusion:The presence of a modified Alvarado score &gt; 7 was found to be a dependable aid in the preoperative diagnosis of acute appendicitis. In cases where the score was negative or equivocal, ultrasonography greatly helped in the diagnosis thereby reducing the incidence of negative appendicectomies.

Background: Acute appendicitis is the acute inflammation of appendix which is the most common cause of acute surgical emergencies. Appendicitis can mimic other pathologies. Removing normal appendix is an economical burden both on patients and health resources. Misdiagnosis and delay in surgery can lead to complications like perforation and finally peritonitis.Methods: This was prospective comparative study carried out in 200 patients over the period of 2 years. Patients with clinical features of acute appendicitis and fitting in inclusion and exclusion criteria were selected. Detailed history was noted and clinical examination was done. Necessary investigations were done, modified Alvarado score was calculated and all were subjected to ultrasonography of abdomen and pelvis. Intra operative findings were noted about nature of appendix and histopathology findings were noted.Results: The sensitivity of ultrasound is 78.19% and specificity is 50%. The sensitivity of modified Alvarado scoring system is 78.7% and specificity is 25%. Negative appendicectomy rate in the study was 6%.Conclusions: Modified Alvarado score has slightly higher sensitivity and ultrasound imaging has higher specificity of in the diagnosis of acute appendicitis and in decreasing negative appendicectomy rates. Ultrasound imaging provides good supportive diagnosis in cases of low or equivocal modified Alvarado scores.

Background :Acute appendicitis is one of the most common surgical emergencies with a lifetime prevalence of approximately 1 in 7. The Alvarado scoring system and ultrasonography play a definite role in diagnosis of acute appendicitis, because of the easy availability, cost effectiveness and being radiation free. According to the analysis, the percentage of Appendicectomies done for a normal appendix mistaken to be Acute Appendicitis was found to be as high as 20%.The following study compares the accuracy of the Alvorado scoring system and Ultrasonography in the diagnosis of Acute appendicitis and examines the value of using both modalities together. Materials and Methods :In this study 100 patients were included with provisional diagnosis of acute appendicitis and admitted and operated in the Department of General Surgery, MGM Medical College, Navi Mumbai between January 2021 to November 2022. Alvarado score was applied and ultra sound abdomen was done pre operatively. The decision for surgery was made independent of the score and ultra sound finding. Diagnosis of patients who underwent appendicectomy was confirmed by histopathology report. Results :In the present study, 100 cases were provisionally diagnosed of having acute appendicitis and were operated during the study period.Itwas seen that 95.52% of patients who were thought to be positive by Alvarado score &gt;=7 usually had appendicitis by histopathology where as 4.08% of the patients were normal by histopathological examination. This accounted for 47.96% and 33.33% of the total patients respectively. From this the sensitivity of the Alvarado score is calculated to be 47.96%. Ultrasound alone showed a PPV of 67% and a NPV of 66.7%. Conclusion :In our study, Alvarado score had better sensitivity than ultrasonography. Alvarado score has a high diagnostic value (97.7%). USG has role in ruling out normal appendix and other pathology, with a specificity of 66.67% When we diagnose acute appendicitis based on the individual results of Alvarado score and USG, we get a statistically significant value. Hence as a conclusion of this study, alvaradoscore and USG together could be applied in the diagnosis of acute appendicitis for better outcomes and decision making.

Background: Appendicitis is notorious in its ability to simulate other conditions and in the frequency, it can be mimicked by other pathologies. The purpose of this study was to evaluate the accuracy of the diagnostic approach incorporating modified Alvarado score system (MASS) and ultrasonography with clinical findings. The aim of the study was to observe and evaluate different modalities of determining appendicitis among the non-pregnant female population of reproductive ageMethods: This prospective descriptive study was conducted at the department of surgery, Rajshahi College and Hospital, Rajshahi, Bangladesh. The study duration was 6 months, from February 2013 to July 2013. The study was conducted with a total of 101 women who were of reproductive age, presenting with right lower quadrant pain, who went through appendicectomy during the study period.Results: The incidence of negative appendicectomy was 4.95% in this study. Most of the patients having appendicitis were in second and third decades with a mean age of 24.79±10.11 years. The rate of perforation in our study was 5.94%. The overall post-operative complication rate was 13.86% with minor wound infection being the most common complication. The accuracy, sensitivity, specificity, PPV and NPV of the diagnostic approach in this study were 95.05%, 98.96%, 20.00%, 95.96% and 50.00% respectively. The accuracy, sensitivity and specificity of ultrasound were found to be 29.47%, 25.56% and 100% respectively.Conclusions: Combined use of clinical diagnosis incorporating modified Alvarado score and ultrasonography led to a significant reduction in the negative appendicectomy rate.

<strong>Aim:</strong>&nbsp;To evaluate the role of Alvarado score and ultrasound in diagnosing and preventing negative laparotomies in acute appendicitis.&nbsp;<strong>Methodology:</strong>&nbsp;A prospective study was conducted on 50 consecutive patients who underwent appendicectomy in the department of general surgery at Sheikh Bhikhari Medical College and Hospital, Hazaribagh, Jharkhand,India, Depending on individual presentation of signs and symptoms, a score was calculated for each case of suspected appendicitis from 10 values (based on the Alvarado scoring system). All patients were clinically examined after taking a detailed history using a structured questionnaire. Then, they underwent blood examination, ultrasound abdomen, followed by surgery. The histopathological examination (HPE) of the specimen was obtained. Finally, the histopathology reports were correlated with the findings of ALVARADO Score and USG abdomen.&nbsp;<strong>Results:</strong>&nbsp;In our study of 80 patients, 31(62%) were male, and 19 (38%) were female. 23 (46%) patients were between 20-29 years of age followed by 14-20 years of age (32%). 50 (100%) of patients were admitted with pain in the abdomen. 39 (78%) complained of nausea or vomiting at admission, 33 (66%) had fever on admission and 41 (82%) of patients had anorexia at the time of admission. All patients (100%) had tenderness in the right iliac fossa. A shift to the left was seen in 40 (80%) of patients.&nbsp;<strong>Conclusion:</strong>&nbsp;According to our study the use of Alvarado Scoring System with USG is more effective and accurate than USG performing alone. It can be recommended to perform USG on each patient with suspected appendicitis and to operate on patients with a USG-supported appendicitis diagnosis and an Alvarado score of 7 and above. &nbsp; &nbsp;

<strong>Background:</strong>&nbsp;Acute appendicitis remains one of the most common surgical diseases faced by the surgeons in practice. It is most common surgical emergency that performed.&nbsp; The diagnosis of acute appendicitis is however challenging, it remained essentially clinical knowledge, a mixture of observation, radiological imaging and reminder of art surgical diagnosis. The main aim to conduct this prospective observational study of acute appendicitis is for early diagnosis and intervention to avoid complications. This studies aim is to early diagnosis and management of acute appendicitis patients admit under General Surgery Dept. Gauhati Medical College &amp; Hospital, Guwahati, Assam.&nbsp;<strong>Materials and Methods:</strong>&nbsp;The study was conducted in the Department of Surgery; Gauhati Medical College during the period 1st may 2021 to 30th April, 2022. It was a prospective observational study. Total 50 patients admitted with clinical and radiological diagnosis of acute appendicitis, under the Department of Surgery were included in the study.&nbsp;<strong>Results:&nbsp;</strong>Acute appendicitis is more common in males than females and the highest incidence is in 2nd and 3rd decade of life. 26 Male and 24 Female patients having a ratio of 1.08:1. The patients presented with symptoms of pain in RIF (98%) of patients followed by anorexia (54%), nausea and vomiting (66%). RIF tenderness present in 100% of patients. The patients were examined clinically thoroughly by using modified Alvarado Scoring system, 48% of the patients shown modified Alvarado score &gt;7and among 71.4% in male and 70% were female patients. The patients were subjected to investigation like routine blood examination, total count &gt;10000 in 56% of patients. Ultrasonography has diagnosed 58% of cases as acute appendicitis 19 of the total cases which had Alvarado score of &gt;7 was managed surgically and the remaining all patients with score of &lt;7 also operated because of clinical symptoms and signs. C T scan was advised for selected patients only. All the cases were confirmed for diagnosis of acute appendicitis based on intraoperative and histopathological findings. Out of 50 patients 45 patients did not have any complication, 3 patients were having gangrenous appendix and 2 patients were having perforated appendix intraoperatively. Histopathologically confirmed cases were 70.8% and overall negative appendicectomy rate in 6% in females and 4% in male.&nbsp;<strong>Conclusion:&nbsp;</strong>Ultrasonography increases the diagnostic accuracy in the patients with suspected acute appendicitis. The modified Alvardo scoring system combined with ultrasonography can therefore be used as an inexpensive way of confirming acute appendicitis reducing negative appendicectomy rate. Currently, CT and graded compression colour Doppler ultrasonography are generally employed to aid in the diagnosis. &nbsp; &nbsp; &nbsp;

Background: The vagaries of presentation and the variability of signs in acute appendicitis are such that even the most experienced surgeons may remove normal appendices or conserve those with perforation. Diagnostic scoring systems and imaging techniques may reduce the number of unnecessary appendectomies.Methods: 75 patients who presented with acute right Iliac fossa pain were analyzed using four different scoring systems. An abdominal ultrasound was also performed when necessary. The results of these scores, USG findings were compared to the intra operative findings and final histopathological report.Results: The Alvarado score had the best positive predictive value with high sensitivity. The Fenyo score was most sensitive for males, whereas the Teicher score was most sensitive for females. The Teicher score was the most specific. The Ohmann score had the highest negative predictive value. Ultrasonography showed a low sensitivity and specificity.Conclusions: There was a 24% negative appendicectomy rate in our study. The Alvarado score is ideal for borderline cases where a quick decision needs to be taken. Ohmann’s score can be used to rule out appendicitis in the casualty setting as it has the best negative predictive value. Fenyo and Teicher’s score with their high sensitivity can be used to reduce the number of negative appendicectomies.