VALIDITY OF ALVARADO SCORING SYSTEM IN DIAGNOSIS OF ACUTE APPENDICITIS

Abstract

BACKGROUND: The first appendectomy was performed by Claudius Amyand in 1736 when he was
operating on a boy for hernia and found appendix lying in hernial sac. Reginald Fitz introduced the word
appendicitis in 1886 and before that it was called typhlitis or perityphlitis.Frederick Treves performed
the lstappendicle surgery in England for the new disease ‘appendicitis’ in 1887.
OBJECTIVE: To study the accuracy of modified Alvarado scorning system in diagnosis of acute
appendicitis.
MATERIAL & METHODS: This descriptive cross sectional study was conducted at DHQ Hospital
Timergara Dir lower from January 2015 to July 2015 to find out the accuracy of Alvarado Scoring
system in the diagnoses of acute appendicitis. A total of 50 patients admitted in surgical ward from OPD
and Casualty with suspected appendicitis were included in the study. Patients less than 7 years and
patients with mass right iliac fossa were excluded. Every patient was evaluated with modified Alvarado
scoring system on a standard Proforma. Patients with Alvarado score of > 6 underwent appendectomy.
The removed appendices were sent for histopathology to confirm or otherwise the provisional diagnosis
of acute appendicitis and hence the accuracy of Alvarado scoring system.
RESULTS: Out of 50 patients, 20 were male &30 were female with a male to female ratio of 1:1.5. The
mean age of the patients was 19.7 ± 9.6years. The mean Alvarado score was 7.92 ± 1.383. The
Histopathology reports of the specimens of 37 patients were confirmative of acute appendicitis whereas
the rest of the (13 patients) removed appendices were reported normal by histopathalogist. So the
sensitivity is 74%.
CONCLUSION: Our study shows that Alvarado scoring system is a simple and quick tool in the
evaluation and management of suspected cases of acute appendicitis. Its accuracy increases if used in
patients above 14 years of age.
KEYWORD: Alvarado scoring system, Appendicitis, Accuracy.