Accuracy and diagnostic approach of combining multiple modalities for diagnosing appendicitis among non-pregnant female of reproductive age

Abstract

Background: Appendicitis is notorious in its ability to simulate other conditions and in the frequency, it can be mimicked by other pathologies. The purpose of this study was to evaluate the accuracy of the diagnostic approach incorporating modified Alvarado score system (MASS) and ultrasonography with clinical findings. The aim of the study was to observe and evaluate different modalities of determining appendicitis among the non-pregnant female population of reproductive ageMethods: This prospective descriptive study was conducted at the department of surgery, Rajshahi College and Hospital, Rajshahi, Bangladesh. The study duration was 6 months, from February 2013 to July 2013. The study was conducted with a total of 101 women who were of reproductive age, presenting with right lower quadrant pain, who went through appendicectomy during the study period.Results: The incidence of negative appendicectomy was 4.95% in this study. Most of the patients having appendicitis were in second and third decades with a mean age of 24.79±10.11 years. The rate of perforation in our study was 5.94%. The overall post-operative complication rate was 13.86% with minor wound infection being the most common complication. The accuracy, sensitivity, specificity, PPV and NPV of the diagnostic approach in this study were 95.05%, 98.96%, 20.00%, 95.96% and 50.00% respectively. The accuracy, sensitivity and specificity of ultrasound were found to be 29.47%, 25.56% and 100% respectively.Conclusions: Combined use of clinical diagnosis incorporating modified Alvarado score and ultrasonography led to a significant reduction in the negative appendicectomy rate.