Abstract
Objective: The aim of our study was to propose a solution for rationalizing requests for ultrasound examination and CT scan in suspected acute appendicitis, based on use of the Alvarado score. Patients and Methods: We included in our study all patients consulting for pain of the right iliac fossa, whatever their age and sex, who had been diagnosed with acute appendicitis and who had undergone appendectomy. We used the Alvarado scoring system, based on clinical items and laboratory measurements, to diagnose appendicitis. Results: One hundred eleven patients, of whom 77 were men (69.4%) and 34 were women (30.6%), with a sex ratio of 2:2.6, were included. Mean age was 31.29 ± 1.31 years, with a range of 1 to 81 years. The diagnosis of definite appendicitis was established in 54 patients (48.6%). Abdominal ultrasound examination had been performed in 80 patients (72.1%). It established a diagnosis of appendicitis in 69 patients (86.2%), while in 11 patients (13.8%) the appendix was described as normal or was not visualized. Conclusion: Our study demonstrated good agreement between peroperative diagnosis and the result of the Alvarado score applied a posteriori. Ultrasound was not always contributory to the diagnosis of acute appendicitis. It could be reserved for patients whose clinical and laboratory score indicated that appendicitis was unlikely.
Highlights
Acute appendicitis is the most common surgical emergency [1]
The aim of our study was to propose a solution for rationalizing requests for ultrasound examination and CT scan in suspected acute appendicitis, based on use of the Alvarado score
Patients and Methods: We included in our study all patients consulting for pain of the right iliac fossa, whatever their age and sex, who had been diagnosed with acute appendicitis and who had undergone appendectomy
Summary
Acute appendicitis is the most common surgical emergency [1]. The diagnosis, classically considered to be clinical, is simple in the typical form of appendicitis but in certain cases it may require abdominal ultrasound, or even abdominal CT scan.Performance of imaging investigations raises two problems in developing countries of the sub-Saharan region. The second is related to the financial and geographical accessibility of these investigations, even when they are available. For these reasons, their prescription often leads to extra expenditure that is a burden for disadvantaged populations who have no health insurance coverage. Their prescription often leads to extra expenditure that is a burden for disadvantaged populations who have no health insurance coverage This may lead to a delay in diagnosis, a source of complications which can be fatal [2]. Over-diagnosis of appendicitis may lead to unnecessary appendectomy, exposing the patient to the risks of complications inherent in any surgical procedure
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