Comparative Study between Modified Alvarado Score and Abdominal Ultrasound Diagnostic Value of Acute Appendicitis in Children

Abstract

Background: Diagnosis of acute appendicitis depends mainly on clinical diagnosis. However, the high negative rate remains a challenge and different aids for diagnosis had been proposed. The aim of the work: The current work aimed to assess the sensitivity of Modified Alvarado Score [MAS] in diagnosis of acute appendicitis. Patients and Methods: One hundred children with clinical manifestations of acute appendicitis were included. Patients were categorized into two groups according to MAS: [group A] included 50 patients with [MAS] ≥ 7 regardless of sonography results. The second group [group B] included another 50 patients with MAS <7 and abdominal ultrasound study suggestive for appendicitis. Intraoperative diagnosis had been performed for 100 patients with postoperative histopathological study for all cases.Results: Tenderness in right iliac fossa was the most frequent sign in the study population [98%]. Histopathology revealed positive results among 49 patients [47 in group A and 2 in group B] with significant difference between groups A and B. The overall sensitivity and specificity of ultrasonography were 89.4% and 33.3% respectively and were 96.0% and 20.0% respectively of MAS score. Conclusion:In acute appendicitis, MAS is a good diagnostic [sensitive] tool. Sensitivity increased when combined with ultrasound, as the number of negative appendectomies was reduced.

Diagnostic Accuracy of Modified Alvarado Score and Pelvi-Abdominal Ultrasound in Diagnosis of Acute Appendicitis

“…Furthermore, the present study in consistent with Rizk et al (1) who illustrated that the sensitivity of Modified Alvarado score was (96.0%) while the sensitivity of ultrasound (89.4%). In contrast, our results in disagreement with Kansakar et al (18) who demonstrated that ultrasound had higher sensitivity (74.19%) and accuracy (75.0 %) as compared to Modified Alvarado score for diagnosis of appendicitis.…”

“…It includes neutrophilic infiltration of the muscularis propria. This confirms the clinical pre-operative diagnosis and exclude missed one (1) .…”

“…The patient demographics and clinical manifestation were recorded in table (1). The patient age ranged between 18 and 70 years and the mean age was 29.2 years.…”

“…Otherwise, in female adolescents, the gynecological causes are more expected. However, the commonest surgical etiology is the acute appendicitis among children and adolescents (1)(2)(3) .…”