CLINICOPATHOLOGICAL STUDY OF ACUTE APPENDICITIS – CORRELATION OF ALVARADO SCORING SYSTEM WITH INTRA OPERATIVE AND HISTOPATHOLOGICAL FINDINGS

Abstract

BACKGROUND/ OBJECTIVE- Acute appendicitis (AA) is one of the most common surgical emergencies that require a proper diagnosis to avoid a negative outcome in the case of missed or delayed diagnosis. Our study aims to assess the diagnostic power of the Alvarado score and the prediction of the severity of acute appendicitis in correlation to intraoperative ndings and the nal histopathology (HP) result. METHODSPatients with suspicion of acute appendicitis were selected for the study, which were divided into 3 groups based on their ALVARADO scoring system after routine blood investigations and ultrasonography. Out of the 100 patients RESULTS- 53 were male and 47 were females.The number of patients were highest in the age group 21- 30 years [45%] indicating predominance in younger age group. Amongst them, 81 were operated and 19 were managed conservatively. Out of 81 patients operated, intra operatively 8 patients were found to have appendicular abscess and 7 patients had a perforated appendix, rest of the 66 patients had features of inamed appendix. These ndings were further conrmed on histopathological reporting. Only 2 cases were missed by Alvarado scoring, but both patients had increased scores on reassessment and they were operated. Complex or more advanced disease was encountered in patients with higher Alvarado score. In this study the sensitivity, specicity, positive predictive value and negative predictive value were 97.5%, 68.4%, 92.94% and 86.6% respectively. Alvarado Scoring Sy CONCLUSION- stem has a high sensitivity. The Alvarado scoring system in patients with pre- operative clinical diagnosis of appendicitis has been useful in the early diagnosis of acute appendicitis as demonstrated by various studies and was helpful in reducing the incidence of negative appendicectomies without increasing the morbidity and mortality. Difculty in surgery can be anticipated in patients with high Alvarado scores.