Abstract
Introduction: Diagnostic wanderings of acute appendicitis are responsible for serious complications or abusive appendectomies. Existing Clinico-biological scores are efficient. Objective: To determine the diagnostic efficiency of Francois’ score in acute appendicitis. Methodology: over 10 months, all the patients admitted in the CHUD-Parakou Emergency Department for pain in the right iliac fossa had been examined by resident students who calculated Francois’ score. After verification by the surgeon, patients were put into three categories: category 1 score ≥ 2; category 2, score between -6 and 2; category 3, score below -6. Sensitivity and specificity were calculated. Results: out of 54 patients selected (29 men and 25 women), 29 were classified as group 1; 19 as group 2 and 6 as group 3. An ultrasound was performed in all patients in group 2, and signs in favor of appendicitis were found in 12 patients. Of the 41 appendicectomies performed, the histologic analysis of 33 operative specimens found a pathological appendix. Sensitivity, specificity and negative predictive value per group were 100%. It has prevented almost in one every four patients (24.07%) an abusive appendectomy. Conclusion: This score would reduce diagnostic wanderings and target patient groups for imaging studies.
Highlights
Diagnostic wanderings of acute appendicitis are responsible for serious complications or abusive appendectomies
Methodology: over 10 months, all the patients admitted in the CHUD-Parakou Emergency Department for pain in the right iliac fossa had been examined by resident students who calculated François’ score
An ultrasound was performed in all patients in group 2, and signs in favor of appendicitis were found in 12 patients
Summary
Diagnostic wanderings of acute appendicitis are responsible for serious complications or abusive appendectomies. Objective: To determine the diagnostic efficiency of François’ score in acute appendicitis. Sensitivity, specificity and negative predictive value per group were 100% It has prevented almost in one every four patients (24.07%) an abusive appendectomy. Conclusion: This score would reduce diagnostic wanderings and target patient groups for imaging studies. The most common non-traumatic abdominal surgical emergency, the incidence of acute appendicitis varies between 100 - 122 cases per 100 thousand inhabitants in the West [1] [2]. In Africa, its frequency is 63.4% in the Central African Republic [3], 40.4% in Benin [4] and in Mali It was ranked as the second non-traumatic surgical emergency after intestinal occlusion [5]. The objective of this study was to verify the reproducibility of the score and to verify its diagnostic efficiency
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