[Right iliac fossa pain and Alvarado Score]

Abstract

Introduction: Unsuspected or undiagnosed acute appendicitis could progress to a perforation or could lead to the removal of a normal appendix.

Objectives: using a clinical score system as a diagnostic tool for this pathology and can decrease negative appendectomies.

Material and method: Prospective and protocolized study.

Setting: National Clinicas Hospital. Córdoba. Argentina. Between May 2007 and June 2007 224 patients were studied of which 117 were male and 107 were female with a mean age of 26.65 years. An Alvarado score was performed on all patients on admission. Based on the clinical evidence and a second assessment with the Alvarado Score, surgical exploration was decided in 207 patients. The remaining 17 were excluded due to other pathology. The diagnosis of acute appendicitis was confirmed by surgical finding and histopathological studies.

Results: In the surgical findings it was shown that 189 (91%) patients had acute appendicitis. There was no surgical mortality. As regards morbidity, 3.86% had medical and 27% had surgical complications. The histopathology reports showed a normal caecal appendix in 18. Whereas the incidence of negative appendicectomy was about 8.69%.

Conclusions: The use of the Alvarado Score together with the surgical and histopathology findings confirmed it was sensitive from 6 points for the diagnosis of acute appendicitis.