Title: A Comparative Study of Ultrasonography and Different Scoring Systems in Diagnosing Cases of Acute Appendicitis
Authors: Digbijay Kumar Singh, Binit Prasad, Ashwini Kumar
DOI: https://dx.doi.org/10.18535/jmscr/v8i3.41
Abstract
Background: Accurate diagnosis of acute appendicitis is still challenging task in some patient’s despite of wide availability of diagnostic methods. The purpose of this study to identify the accurate diagnostic tool for acute appendicitis.
Research Design and Methods: The study was conducted on 50 patients of age group 14 to 60 years, who had diagnosed as a case of acute appendicitis clinically. Data was collected as RIPASA, Lintula, Alvarado score and ultrasonography findings. Statistical analysis was done and results of all four scoring systems were compared with ultrasonography for diagnostic accuracy. Histopathological finding of resected specimens was considered as a final diagnosis.
Results: RIPASA score we found sensitivity of 86.84%, specificity of 66.60% and diagnostic accuracy of 82%, Alvarado score we found sensitivity of 86.84%, specificity of 58.66%, and diagnostic accuracy of 80%, Lintula score we observed sensitivity of 81.57%, specificity of 58.33% and diagnostic accuracy of 76%. We observed that ultrasonography had sensitivity of 89.47%, specificity of 83.33%, and diagnostic accuracy of 88%.
Conclusions: The present study concluded that ultrasonography is the most accurate diagnostic method among the above scoring systems in diagnosing case of acute appendicitis.
References
Hoffman J, Rasmussen O. Aids in the diagnosis of acute appendicitis. Br J Surg. 1989;76:774-79.
Inamdar MF, Manjappa S, Inamdar NM. A clinico pathological study of acute appendicitis with special reference to ultrasonography. International Surgery Journal. 2017 Apr 22;4(5):1647–52.
Jaffe BM, Berger DH, “The Appendix”, “Chapter 30in Schwartz’ principles of surgery”. Bruniadi F, Anderson DK, Biliar TR, Dunn DL, Hunter JG, Pollock RE, 9thEdn, McGraw Hill medical publishing division, New York, 2005;1073-1089.
Chong CF, Adi MIW, Thien A, suyoi A, Mackie AJ, Tin AS et al. Development of the RIPASA score: a new appendicitis scoring system for the diagnosis of acute appendicitis. Singapore Med J 2010;51(3): 220-225.
Kanumba ES, Mabula JB, Rambau P, Chalya PL. Modified Alvarado Scoring System as a diagnostic tool for Acute Appendicitis at Bugando Medical Centre, Mwanza, Tanzania. BMC Surg. 2011 Feb 17;11:4.
Lintula H, Kokki H, Jukka P, Pulkkinen J, Kettunen R, Grohn O et al. Diagnostic score in acute appendicitis. Validation of a diagnostic score (Lintula score) for adults with suspected appendicitis. Langenbecks Arch surg 2010;395:495-500.
Chong CF, Thien A, Mackie AJ, Tin AS, Tripathi S, Ahmad MA, et al. Comparison of RIPASA and Alvarado scores for the diagnosis of acute appendicitis. Singapore Med J. 2011 May;52(5):340–5.
Alvarado A: Apractical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986,15:557.