Abstract
<i>Background</i>: Preoperative diagnosis of acute appendicitis is classically a clinical one, but with the increasing use of technology for arriving at a fool proof diagnosis, surgeons rely on radiology to a considerable extent for decision making. Especially, in developing countries where time and resources are limited, a reliable Ultrasonography (USG) based score for diagnosing acute appendicitis improves decision making. This prospective study was carried out to compare Modified Alvarado Score & Tzanakis’s Score for diagnosing acute appendicitis. <i>Methods</i>: 146 patients undergoing emergency appendectomy for suspected acute appendicitis were included in the study. This was a prospective study carried out from July 2014 to March 2016. Patients included in the study were scored according to Modified Alvarado Score (MAS) and Tzanakis Score (TS). The final diagnosis was confirmed by histopathology. Results: The sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratio of MAS were 94.95%, 92.6%, 98.26%, 80.64% and 0.05 respectively, and of TS were 98.32%, 96.29%, 99%, 92.85% and 0.02 respectively. Negative appendectomy rate was 1.74% for MAS (cutoff ≥7) and 0.84% for TS (cutoff ≥8). Overall negative appendectomy rate was 18.5%. <i>Conclusion</i>: Tzanakis score is simple, applicable and effective for diagnosing acute appendicitis.
Highlights
The term “appendicitis” was not used until Reginald Fitz described this condition in 1886.1 Acute appendicitis is one of the most common causes of abdominal surgical emergencies with a lifetime prevalence of approximately 1 in 7 worldwide.[2]
It is associated with high morbidity and occasional mortality related to the failure of making an early diagnosis
It has been estimated that approximately 6% of the population will suffer from acute appendicitis during their lifetime; much effort has been directed toward early diagnosis and intervention.[3,4]
Summary
The term “appendicitis” was not used until Reginald Fitz described this condition in 1886.1 Acute appendicitis is one of the most common causes of abdominal surgical emergencies with a lifetime prevalence of approximately 1 in 7 worldwide.[2]. The patient describes the pain as beginning in the periumbilical or epigastric region and migrating to right iliac fossa This is associated with fever, anorexia, nausea, and vomiting. This “classic” symptomatology only occurs in 50-60% of cases making the diagnosis difficult.[5] Difficulties in diagnosis especially arise in very young, elderly patients and females of reproductive age because they are more likely to have an atypical presentation, and many other conditions may mimic acute appendicitis in International Journal of Clinical and Experimental Medical Sciences 2016; 2(5): 90-93 these patients.[6] A negative appendectomy rate of 20-40% has been reported in the literature and many surgeons advocate early surgical intervention for the treatment of acute appendicitis to avoid perforation, accepting a negative appendectomy rate of about 15-20%.7. In developing countries where time and resources are limited, a reliable Ultrasonography (USG) based score for diagnosing acute appendicitis improves decision making This prospective study was carried out to compare Modified Alvarado Score & Tzanakis’s Score for diagnosing acute appendicitis. Conclusion: Tzanakis score is simple, applicable and effective for diagnosing acute appendicitis
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