The use of ultrasonographic and Alvarado scores in evaluating abdominal pain suggestive of acute appendicitis

Abstract

Background: Ultrasonographic scores for appendicitis to determine if, combined with Alvarado scores, they can increase the sensitivity and specificity of the diagnosis of appendicitis.Methods: All cases of abdominal pain suggestive of appendicitis presented between 2013 and 2015 were analysed. An Alvarado score was obtained. All patients underwent ultrasound, and an ultrasonographic score was determined, including the appendicitis classical findings.Results: Two hundred and fifty-one patients with abdominal pain in the right lower quadrant were analysed. Appendicitis was confirmed in 211 (84%) patients. For these patients, the average Alvarado score was 7.95/10 (±1.25) vs. 5.7/10 (± 1.11) for patients who did not have appendicitis (p < 0.001). In patients with confirmed appendicitis, the average ultrasonographic score was 2.48/6 (± 1.06) vs. 0.6/6 (± 0.92) for patients who did not have acute appendicitis (p < 0.001). The ultrasonographic score has a sensitivity of 90% and a specificity of 87% with only two parameters. The combination of the Alvarado and ultrasonographic scores decreased the percentage of negative appendectomies to 2.36% and increased the area under the curve by 0.970.Conclusions: The sum of the Alvarado and ultrasonographic scores provides an efficient alternative for diagnosing abdominal pain suggestive of appendicitis and predicts which patients should undergo surgery with good certainty.

Assessment of the Diagnostic Reliability of Modified Alvarado Scores and Abdominal Ultrasonography in Acute Appendicitis

“…A score of seven or more is considered highly suggestive of acute appendicitis. Similarly, patients were subjected to USG abdomen, findings were noted, and appropriate sonologic scores were calculated (anteroposterior diameter > 6mm (score 1), non-compressible tubular structure (score 1), echogenic changes in the periappendicular fat (score 1), thickness of appendicular wall > 2mm (score 1), target sign (score 1), appendicolith (score 1) for a total score of six [ 10 ]. Histopathological diagnosis of acute appendicitis was regarded as confirmatory in these cases, and it was correlated with individual MAS and USG scoring, and the two combined to arrive at a diagnosis.…”