Original Research Article
Year: 2020 | Month: May | Volume: 7 | Issue: 5 | Pages: 14-21
Evaluation of Alvarado Score in the Diagnosis of Acute Appendicitis in Tertiary Care Centre of Kumaun Region
Chandresh Gangwar1, Pankaj Kumar Verma2, S.R. Kala2
1Postgraduate Resident, 2Associate Professor,
Department of General Surgery, Government Medical College, Haldwani, District – Nainital
Corresponding Author: Pankaj Kumar Verma
ABSTRACT
Introduction – In attempts to increase the diagnostic accuracy and reduce the high rate of negative appendicectomy, physicians recommended the use of the Alvarado score in predicting the presence or absence of appendicitis. The main aim of our study is to evaluate the diagnostic accuracy of Alvarado score in acute appendicitis in patients of Kumaon region and correlate the clinical, peroperative and histopathological findings with each other.
Methods - Patients were assessed in the casualty, and Alvarado score was obtained for all patients within 48 hours from the onset of the symptoms and the majority within 24 hours. If patients were thought on clinical evaluation to require appendicectomy, then this was performed, regardless of the score. Intraoperative findings were recorded and specimen of appendix was sent for histopathological examination. Pathological findings were observed and were compared with the Alvarado score.
Results – Alvarado score for histologically proven normal appendix was minimum whereas those for dull serosa with transmural infiltration of polymorphs with areas of hemorrhage and necrosis were maximum. Statistically there was a significant correlation between total score and histopathological findings.
Conclusion - Alvarado score was found to be simple and easy to apply, since it relies only on history, clinical examination and routine laboratory investigations. Alvarado score provides an economical alternative to the other available costly diagnostic modalities such as CT scan, MRI scans etc.
Keywords: Appendicitis, Alvarado score, Appendicectomy
[PDF Full Text]