Continuing diagnostic challenge of acute appendicitis: evaluation through modified Alvarado score

Abstract

Background: Acute appendicitis with protean manifestations may simulate almost any other acute abdominal illness and in turn may be mimicked by a variety of conditions. Progression of symptoms and signs is usual in contrast to the fluctuating course of some other diseases that lead to heavy morbidity and mortality.

Methods: A practical score for the early diagnosis of acute appendicitis was established by Alvarado in 1986 and was assessed in this study for its accuracy in pre-operative diagnosis. The usefulness of this scoring system in reducing the evaluated negative appendicectomy rate of acute appendicitis in 91 patients, diagnosed by clinical parameters only, over a period of 12 months is determined.

Results: A total of 106 patients underwent Alvarado scoring in emergency surgical service at SK Institute of Medical Sciences, Srinagar Kashmir, India.

Conclusions: The high scores in men and children were found to be an easy and satisfactory aid in the early diagnosis of acute appendicitis, but a high false-positive rate for acute appendicitis was found in women.