Diagnostic Challenge of Acute Appendicitis: Appraisal through Modified Alvarado Score

Abstract

Acute appendicitis is one of the commonest surgical emergencies. Simple appendicitis can progress to perforation, which is associated with a much higher morbidity and mortality, and surgeons have therefore been inclined to operate when the diagnosis is probable rather than wait until it is certain. Routine history and physical examination still remain most practical diagnostic modalities. Absolute diagnosis of course is only possible at operation and histopathological examination of the specimen. For this reason rate of negative Appendicectomy as reported in the world literature varying from 20-40%. The present study was undertaken in DMC&H from Jan 2013 to June 2013 to evaluate the usefulness of Modified Alvarado scoring system in reducing the number of negative appendicectomy and to evaluate its sensitivity & positive predictive value in the diagnosis of acute appendicitis. In this study the negative appendicectomy rate is 10.00% with the rate being equal in females (10%) and males (10%).