A practical score for the early diagnosis of acute appendicitis

A, Alvarado Durán

doi:10.1016/s0196-0644(86)80993-3

Cited by 1,267 publications

(877 citation statements)

References 8 publications

Supporting

Mentioning

802

Contrasting

Unclassified

Order By: Relevance

“…The importance of pain migration to the right lower quadrant has earlier been shown by others [20]and was also emphasised in two systematic reviews [22, 23]. In contrast, analyses of patients admitted for acute abdomen have revealed that clinical signs like tenderness, rigidity and rebound tenderness are useful in making a preoperative diagnosis of acute appendicitis [7, 8, 17]. …”

Section: Discussionmentioning

confidence: 97%

“…Diagnostic accuracy (DA) varies between 70 and 80%, and differs considerably between patient groups [2, 3, 4]. To improve DA, several diagnostic tools, such as diagnostic scores, ultrasound examination and CT scan have been evaluated [5, 6, 7, 8, 9, 10]. However, their importance and usefulness remain uncertain [11, 12].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, diagnostic laparoscopy was introduced [13, 14, 15], but invasive methods require hospital resources and lead to complications. The importance of clinical symptoms and signs in the diagnosis of acute appendicitis has been addressed in recent studies [4, 8, 16, 17, 18, 19, 20, 21, 22, 23]. Most of them evaluated clinical variables by comparing patients operated for acute appendicitis with those who were managed conservatively.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The History Is Important in Patients with Suspected Acute Appendicitis / with Invited Commentary

et al. 2000

View full text Add to dashboard Cite

Background/Aims: The clinical diagnosis of acute appendicitis is incorrect in 20–30% of patients undergoing surgery. We analysed the clinical importance of nine commonly used symptoms and signs in 544 consecutive patients with regard to the correct diagnosis of acute appendicitis. Methods: Open population-based prospective study. The degree of the surgeon’s certainty of the preoperative diagnosis was assessed. The final diagnosis was based on histology. Logistic regression was used to analyze the independent value of nine symptoms and signs to predict acute appendicitis by calculating odds ratio (OR) with 95% confidence intervals (CI). Results: In 434 of 544 patients (80%) acute appendicitis was confirmed. A history of nausea or vomiting (OR = 2.3; CI = 1.11 to 4.76) and pain migration to right iliac fossa (OR = 1.9; CI = 1.12 to 3.22) were significant predictors of acute appendicitis. Pain migration was found to be an independent predictor in females and nausea or vomiting in males. In the group of patients (29%) with an uncertain preoperative diagnosis, pain migration predicted a correct diagnosis in females (OR = 4.7; CI = 1.2 to 18), while tenderness over McBurney’s point was a significant predictor in males (OR = 8.3; CI = 1.1 to 63). Conclusions: A history of pain migration and nausea or vomiting were independent predictors for the correct diagnosis of acute appendicitis in patients undergoing surgery. Thus, patient history is important in this patient group.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The History Is Important in Patients with Suspected Acute Appendicitis / with Invited Commentary

et al. 2000

View full text Add to dashboard Cite

show abstract

“…Therefore several scoring systems have been developed to aid in early diagnosis of acute appendicitis so that the rate of negative appendectomies can be reduced to 0-5%. [9] Alvarado scoring system9 developed in 1986 comprising of 8 parameters.…”

Section: Introductionmentioning

confidence: 99%

The Prospective Study to Evaluate the Efficacy of ALVARADO Score and RIPASA Score in Diagnosis of Acute Appendicitis and Correlation with Histo- Pathological Findings

Singla¹,

Gupta²,

Attarde³

et al. 2018

AIMDR

View full text Add to dashboard Cite

Background: Acute abdomen is one of the most common surgical emergencies with the life time risk of 7%. The diagnosis of appendicitis is challenging due to overlapping of symptoms with other diseases and variable accuracy of clinical examination. The present study was carried out to diagnose acute appendicitis and its complications, to compare ALVARADO and RIPASA scoring systems and correlating these with intra-operative and histopathological findings. Methods: This prospective study of 100 patients was conducted in Department of Surgery admitted in Muzaffarnagar Medical College and Hospital, Muzaffarnagar. Any patients irrespective of sex admitted with age more than 13 yrs presented with right iliac fossa pain suspected to be acute appendicitis and underwent appendectomy. Diagnosis of acute appendicitis was confirmed by operative findings and histological assessment of the appendectomy specimen. In every clinically diagnosed case, ALVARADO and RIPASA scoring systems were applied. Patients were monitored following admission, surgery and till discharge from the hospital. Intra-operative findings such as length of appendix, site of appendix, presence of gangrene or nor, free fluid present or not, presence of fecolith or not, base of caecum evaluated. Histopathologic findings of operated case were collected and correlated with either scores. Results: Out of 100 patients 64% were males and 36% were females. When Alvarado score applied in the study group; 55 patients were in > 7 group and 45 patients in < 7 group. When correlate with histopathology, 90% patients fall into acute appendicitis group and 10% in nonappendicitis group. RIPASA score revealed that there were 89% patients in high probability of acute appendicitis, while 11% were in low probability. When correlate with histopathology 90% fall into appendicitis group and 10% in nonappendicitis group. Conclusion: In the study we conclude that for the diagnosis of appendicitis both ALVARADO and RIPASA scoring systems were equally good. However, RIPASA score is a useful rapid diagnostic tool for establishing a quick decision in patients with RIF pain. Moreover, it also reduces the cost of expensive radiological investigations and thus making a more cost effective approach for patients belonging to lower socioeconomic group.

show abstract

“…Inclusion criteria included patients in whom appendicitis was documented clinically or with the help of computed tomography scan results plus Alvarado score of more than five (15,16). Patients, who revealed no signs of appendicitis at surgery and patients with signs and symptoms of perforation peritonitis and its complications, including abdominal guarding, diffuse abdominal rigidity, development of ileus paralyticus, shock, acute renal failure, peritoneal abscess, and sepsis, in addition to patients with marked overweightness defined as body mass index of more than 25, were excluded from the study (n = 12).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Small Access and Classic McBurney’s Incisions for Open Appendectomy: A Randomized Controlled Trial

et al. 2017

View full text Add to dashboard Cite

Background: Many surgeons have been encouraged to use a variety of incisions for abdominal visceral surgery that are hidden from exposure. The current researchers conducted this study to find the safety and feasibility of open appendectomy using Small Access (SA) incision and compare this method with the classic McBurney's appendectomy (CA). Methods: Sixty-nine patients with the diagnosis of acute appendicitis at Besat hospital, Hamadan University of Medical Sciences, Iran, during year 2016, were enrolled in the study and were randomly allocated to 2 groups, including SA (n = 39) and CA groups (n = 30). All patients were visited 1 week and 6 months after the surgery. Results: The demographic data of the patients, including gender and age, was not significantly different between the 2 groups (P values = 0.12 and 0.87, respectively). In 6 patients in the SA group, the incision was transversely extended during the operation. There was no significant difference between postoperative complications in the 2 groups. The amount of pain medication administered

show abstract

A practical score for the early diagnosis of acute appendicitis

Cited by 1,267 publications

References 8 publications

The History Is Important in Patients with Suspected Acute Appendicitis / with Invited Commentary

The History Is Important in Patients with Suspected Acute Appendicitis / with Invited Commentary

The Prospective Study to Evaluate the Efficacy of ALVARADO Score and RIPASA Score in Diagnosis of Acute Appendicitis and Correlation with Histo- Pathological Findings

Comparison of Small Access and Classic McBurney’s Incisions for Open Appendectomy: A Randomized Controlled Trial

Contact Info

Product

Resources

About