Abstract
Introduction Being one of the scoring systems used in the diagnosis of acute appendicitis, the RIPASA score can be used easily with a high diagnostic accuracy. Objective To evaluate the possible relationship between RIPASA scores and the histopathological examination results of appendectomy materials. Materials and Methods This study retrospectively reviews 242 patients who were operated in our clinic between January 2016 and January 2018 with a prediagnosis of acute appendicitis, and the RIPASA scores calculated in the preoperative period were compared to the histopathological examination results of the appendectomy specimens. Results The patients consisted of 124 (51.2%) females and 118 (48.8%) males. The ages of the patients ranged from 15 to 81 years. The patients were divided into 3 groups based on their RIPASA scores as low-score (4-7), intermediate-score (7.5-11.5), and high-score (12 and over) groups. There were 20 (52.6%) catarrhal-stage appendicitis cases and 17 (44.7%) normal appendixes in the low-score group; there were 70 (83.3%) catarrhal-stage appendicitis cases, 9 (10.7%) suppurative-stage appendicitis cases, 4 (4.8%) gangrenous-stage appendicitis cases, and 1 (1.2%) perforated appendicitis case in the intermediate-score group. In the high-score group, there were 53 (44.2%) suppurative-stage appendicitis cases, 51 (42.5%) gangrenous-stage appendicitis cases, 11 (9.2%) perforated appendicitis cases, and 5 (4.2%) catarrhal-stage appendicitis cases. A strong positive correlation was found between the RIPASA scores of the patients and the pathological stage of appendicitis (r=0.889; p<0.001). Conclusion The RIPASA scoring system can make a correct and prompt diagnosis of acute appendicitis including its possible pathological stage without any need for a computed tomography.
Highlights
Being one of the scoring systems used in the diagnosis of acute appendicitis, the Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score can be used with a high diagnostic accuracy
We reviewed retrospectively 242 consecutive patients who presented to the General Surgery Clinic in Trabzon Kanuni Training and Research Hospital between January 2016 and January 2018 due to right iliac fossa pain and who were operated with an initial diagnosis of acute appendicitis
Late or incorrect diagnosis leads to aggravation of the existing inflammation, resulting in serious complications including appendicular perforation, peritonitis, intraabdominal abscess, and sepsis, with an increase in morbidity and mortality
Summary
Being one of the scoring systems used in the diagnosis of acute appendicitis, the RIPASA score can be used with a high diagnostic accuracy. Advanced radiological imaging methods such as ultrasonography and computed tomography (CT) are often resorted to for making a quick and accurate diagnosis [3, 4] Despite all these facilities, the rate of negative or unnecessary appendectomy due to reduced diagnostic accuracy has gone up to approximately 30% [2]. The rate of negative or unnecessary appendectomy due to reduced diagnostic accuracy has gone up to approximately 30% [2] Since these radiological tests are not readily accessible in all medical centers and there was a need to lower this high rate of negative appendectomy, some clinical diagnostic systems based on scoring of various clinical and laboratory findings of patients have been developed for diagnosing of acute appendicitis [3, 4]. With a significantly higher sensitivity, specificity, and diagnostic accuracy, the RIPASA score can help clinicians make the diagnosis of acute appendicitis without any extra tests and carry out the correct management of the patient at an early stage
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