Reliability of ultrasonography and the Alvarado scoring system in acute appendicitis

Yazar, Ahmet Sami; Erdoğan, Seher; Şahin, Ceyhan; Güven, Şirin

doi:10.24953/turkjped.2018.02.009

Cited by 7 publications

(10 citation statements)

References 20 publications

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“…We observed similar trend of such higher scores to be associated more with acute appendicitis on CT imaging. Many other studies have evaluated role of imaging compared to Alvarado scores, and demonstrated high Alvarado scores correlating well with imaging even in paediatric population, 9 and pregnant women. 22 However, the beneficial role of CT imaging in patients with equivocal AS scores, where an alternate diagnosis may be established and treated accordingly, is not well emphasized.…”

Section: Discussionmentioning

confidence: 92%

“…Yazar AS and colleagues found a higher AS with positive ultrasonography in children with histopathologically proven acute appendicitis. 9 Moreover, paediatric appendicitis score (PAS) may be used to estimate better clinical condition in these patients. 29,30 Paediatric patients with a stable and low AS may benefit from simple observation after an initial negative ultrasound study, and may be offered a low-dose CT or MR imaging in case of worsening of AS.…”

Section: Discussionmentioning

confidence: 99%

“…High AS scores (more than 6) in adult males are well validated while lower scores (less than 6) in other populations (like females and children) require clinical suspicion and often further investigation including radiologic imaging. [6][7][8] Ultrasound is still important for an initial diagnostic work up patients with right lower quadrant pain, 9 in particular for the paediatric age group and female patients, 10,11 to avoid radiation risks and to exclude any gynaecologic cause in the later group. However, it is operator dependent.…”

Section: B a C K G R O U N Dmentioning

confidence: 99%

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Usefulness of CT Scan in Diagnosing Acute Appendicitis in Patients with Low Alvarado Scores

Waheed¹,

Shah²,

Alshehri³

et al. 2019

jemds

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BACKGROUND Alvarado score has been routinely used in clinical practice for assessing the probability of acute appendicitis in patients presenting with right lower quadrant abdominal pain. Computed tomography can be used for equivocal or difficult cases. We wanted to evaluate role of computed tomography (CT) in patients with low or equivocal Alvarado scores. METHODS This is a retrospective, observational study conducted in the Department of Radiology at our Hospital in Dhahran from October 2017 to October 2018. 138 patients with equivocal Alvarado scores (AS, 4-6) and negative (non-conclusive or limited) ultrasounds, were retrospectively reviewed. Pregnant, postoperative (bowel surgery) cases and chronic appendicitis cases were excluded. Diagnosis of acute appendicitis on CT was based on a thickened or fluid dilated appendix (diameter > 6mm, wall enhancement) with at least one of the associated findings (like appendicolith, peri-appendiceal fat stranding, free fluid, extra-luminal air foci, caecal base thickening and mesenteric lymph nodes). Imaging findings were reviewed by two radiologists and consensus reporting was made. Findings on CT were categorized as AA (Acute Appendicitis), OD (Other Diagnosis) and NOR (Normal). Surgical candidates were confirmed on histopathology, while nonsurgical cases were followed up on either imaging or clinical grounds. Chi-square test was used to determine association. The main outcome measure was diagnosis on CT and histopathology. RESULTS 29.7% (41 patients) were found to have acute appendicitis on CT imaging. Majority of patients with AS of 5 were having OD, while most of AA cases were having AS of 6. All patients with AS of 4 were having normal CT scans. CONCLUSIONS Computed tomography helps to diagnose acute appendicitis or establish an alternate diagnosis in patients with equivocal Alvarado scores.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: B a C K G R O U N Dmentioning

confidence: 99%

See 1 more Smart Citation

Usefulness of CT Scan in Diagnosing Acute Appendicitis in Patients with Low Alvarado Scores

Waheed¹,

Shah²,

Alshehri³

et al. 2019

jemds

View full text Add to dashboard Cite

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“…This validated 27-point scale has four domains of assessment with minimum and maximum scores of 0 and 32, respectively. Based on these scores, the risk of bias was graded as low (score > 23), moderate (16)(17)(18)(19)(20)(21)(22)(23), or high (0-15). The kappa statistics were used to identify the level of inter-rater agreement regarding the risk of bias [11].…”

Section: Quality Assessmentmentioning

confidence: 99%

Mean Platelet Volume in the Diagnosis of Acute Appendicitis in the Pediatric Population: A Systematic Review and Meta-Analysis

et al. 2022

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Background: Mean Platelet Volume (MPV) has been suggested as a biomarker for acute appendicitis (AA) in the adult population. The utility of MPV in pediatric AA remains vague. This systematic review and meta-analysis aimed to systematically summarize and compare all relevant data on MPV as a diagnostic biomarker for AA in children. Methods: Databases were systematically searched using keywords ((mean platelet volume) OR mpv) AND (appendicitis). The inclusion criteria were all comparative studies of MPV in children aged less than 18 years and diagnosed with AA. Two authors independently assessed the methodological quality using the Downs and Black scale. Results: We included fourteen studies in the final meta-analysis; most were retrospective. Eight studies compared the MPV values between AA and non-AA; four studies compared the same between AA and healthy controls; two studies compared the MPV values among all three groups. The estimated heterogeneity among the studies for all outcomes was high and statistically significant. The pooling the data showed no statistically significant difference in MPV (weighted mean difference (WMD) = −0.42, 95% CI = (−1.04, 0.20), p = 0.19) between AA and healthy controls or AA and non-AA cases (WMD = 0.01, 95% CI = (−0.15, 0.17), p = 0.90). Conclusion: While MPV levels seem to have some utility in adult AA diagnosis, MPV levels should not dictate treatment options in pediatric AA.

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“…Appendicitis is one of the most common clinical conditions accounts for referral of patients to the hospital (1). Despite advances in therapeutic and diagnostic techniques, acute appendicitis remains a clinical emergency and is one of the most common causes of acute abdominal pain (2). The early diagnosis of this disease is very important and challenging.…”

Section: Introductionmentioning

confidence: 99%

Epidemiological aspects of patients underwent appendectomy in Birjand, Iran, from May 2017 to 2019

et al. 2019

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Introduction: Appendectomy is one of the most performed surgeries worldwide. There are lots of factors involved in the incidence of appendicitis, and most of them vary among populations. Therefore, the present study aimed to evaluate the epidemiological aspects of appendicitis in Birjand, Iran, for the first time.Methods: This prospective study included 666 cases out of 673 acute appendicitis patients treated surgically in Imam Reza Hospital in Birjand, Iran, from May 2017 to 2019. The data were analyzed regarding gender, age groups, and season in SPSS software (version. 22) using a t-test and the Chi-square test. A p-value less than 0.05 was considered statistically significant. Results:The annual incidence of acute appendicitis in Birjand was 12.74 per 10.000 population with the mean age of 25.43±14.97 years. The highest frequency of appendectomy was observed in 11-20-year-old groups (32.1%) and then in 21-30-year-old groups (27.3%). The frequency of the appendectomy was higher in male than female (P=0.005), and the peak of the surgeries was in the summer. Moreover, the majority of the admitted patients in the summer were male (n=123), whereas the frequency of female patients in the autumn was higher than that of male (n=81). The most frequent pathological diagnosis in both genders was acute gangrenous appendicitis (i.e., 44% in female and 40% in male). Furthermore, the incidence rates of advanced stages of appendicitis, such as "acute supportive appendicitis and periappendicitis" and "acute supportive appendicitis and priappendicitis with perforation" were significantly higher in male than female (P<0.05). Conclusions:The findings of this study provide basic epidemiological information for the first time regarding appendicitis status in Birjand, Iran. Since the appendicitis was more frequent among youth and was more complicated in male, it is essential to inform these target groups about the signs and symptoms of this medical emergency.

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Reliability of ultrasonography and the Alvarado scoring system in acute appendicitis

Cited by 7 publications

References 20 publications

Usefulness of CT Scan in Diagnosing Acute Appendicitis in Patients with Low Alvarado Scores

Usefulness of CT Scan in Diagnosing Acute Appendicitis in Patients with Low Alvarado Scores

Mean Platelet Volume in the Diagnosis of Acute Appendicitis in the Pediatric Population: A Systematic Review and Meta-Analysis

Epidemiological aspects of patients underwent appendectomy in Birjand, Iran, from May 2017 to 2019

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