Publication:

Appendicectomy: to do or not

Background This study is to evaluate the reliability of modified Alvarado scoring system for diagnosis of acute appendicitis and correlate it with acute diagnostic modality. It helps to assess the discrimination and calibration performance of the Alvarado score. It is also useful in evaluating the importance of modified Alvarado scoring system in reducing the percentage of negative appendicitis.

Methods The scoring system is based on three symptoms, three signs and one laboratory finding. The decision to operate is made independently by surgeon. All operated appendices are to be sent for histopathological examination. Then the MAS score is compared with pathology results.

Results In our study we have divided the modified Alvarado scoring system into three groups. The persons with score from 7-10 are more likely to have appendicitis and they are termed as modified Alvarado score positive and other two groups are considered to be modified Alvarado score negative. Out of 50 patients, 32 were considered positive and they underwent appendicectomy irrespective of ultrasonographic findings. Histopathological results were obtained for these patients.

Conclusion From present study, it is concluded that modified Alvarado score is better diagnostic tool than ultrasonography alone in diagnosis of acute appendicitis. It is easy, simple and cheap complementary aid for supporting the diagnosis of acute appendicitis. The overall modified Alvarado scoring system showed high sensitivity and specificity rate, high accuracy rate, high positive predictive value and low appendicectomy rate.