Alvarado score in the diagnostic of pain in the right lower quadrant
DOI:
https://doi.org/10.31053/1853.0605.v74.n3.14568Keywords:
Acute appendicitis. Score system for diagnosis acute appendicitis. Alvarado Score. Palabras claves, Apendicitis aguda. Score clínico para el diagnóstico de apendicitis aguda. Score de Alvarado.Abstract
SUMMARY:
Background: Acute appendicitis neither suspected nor diagnosed could develop a perforation or otherwise it would take to removing of a normal appendix.
Objectives: Utilization of a clinical score system for aided diagnosis of this pathology and can reduce a negative appendicitis.
Setting: National Clinicas Hospital. Córdoba. Argentina.
Design: Prospective and protocolized study.
Methods: 594 patients were studied between October 2002 and December 2013. 312 males and 282 females their age average was 26.2 years. Alvarado score was realized in all patients when they entered. According clinic and second valoration with the score surgical exploration was decided in 574 patients. The remaining 20 were excluded due to other pathology. The diagnosis in acute appendicitis was confirmed by surgical finding and histopathologic studies.
Results: In surgical finding we showed 594 patients (91,28 %) had acute appendicitis. There was no operative mortality. Respects morbidity there was 1,74 % of medical and 13,93 % of surgical complications. The anatomo-pathologic report showed a normal cecal appendix in 50. The incidence of negative appendicectomy was about 8.71 %.
Conclusions: The utilization of score related to the surgical and anatomo-pathologic finding confirmed it was appreciable from 6 points to acute appendicitis diagnosis.
Downloads
References
- Izbicki JR, Knoefel WT, Wilker DK, et al.: Accurate diagnosis of acute appendicitis: a retrospective and prospective analysis of 686 patients. Eur. J. Surg. 1992. 158: 227-231.
- Van Way CW, Murphy JR, Dunn EL, et al.: A feasibility study of computer aided diagnosis in appendicitis. Surg. Gynecol. Obstet. 1982. 155: 685-688.
- Ohmann C, Yang Q, Franke C.: Diagnostic scores for acute appendicitis. Abdominal Pain Study Group. Eur. J. Surg. 1995. 161: 273-281.
- Alvarado A.: A practical score for the early diagnosis of acute appendicitis. Ann. Emerg. Med. 1986. 15: 557-564.
- Lau WY, Fan ST, Yiu TF, et al.: Negative findings at appendectomy. Am. J. Surg. 1984. 148: 375-378.
- Margenthaler J, Longo W. Risk factors for adverse outcomes after the surgical treatment of appendicitis in adults. Ann. Surg. 2003. 238: 59-66
- Yıldırım E, Karagülle E, Kırbaş I, et al.: Alvarado scores and pain onset in relation to multislice CT findings in acute appendicitis. Diagn. Interv. Radiol. 2008. 14: 14-18.
- Douglas CD, Macpherson NE, Davidson P, et al.: Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score. BMJ. 2000. 321: 919-922.
- Hong JJ, Cohn SM, Ekeh AP, et al.: Prospective randomized study of clinical assessment versus computed tomography for the diagnosis of acute appendicitis. Surg. Infect. 2003. 4: 231-239.
- Bongard F, Landers DV, Lewis F.: Diferential diagnosis of acute appendicitis and pelvic inflammatory disease. A prospective analysis. Am. J. Surg. 1985. 150: 90-96.
- Birnbaum BA, Jeffrey RB Jr.: CT and sonographic evaluation of acute right lower quadrant abdominal pain. AJR. 1998. 170: 361-371.
- Garfield JL, Birkhahn RH, Gaeta TJ, et al.: Diagnostic pathways and delays on route to operative intervention in acute appendicitis. Am. Surg. 2004. 70: 1010-1013.
- Shelton T, McKinlay R, Schwartz RW.: Acute appendicitis current: diagnosis and treatment. Curr. Surg. 2003. 60: .502-505.
- Middleton SB, Whitbread T, Morgans BT, et al.: Combination of skin temperature and a single white cell count does not improve diagnostic accuracy in acute appendicitis. Br. J. Surg. 1996. 83: 499-501.
- Ford R, Passinault W, Morse M.: Diagnostic ultrasound for suspected appendicitis: Does the added cost produce a better outcome?. Am. Surg. 1994. 60: 895-898.
- Al Qahtani HH, Muhammad AA.: Alvarado score as an admission criterion for suspected appendicitis in adults. The Soudi Journal of Gastroenterology. 2004. 10: 86-91.
- Turhan AN, Kapan S, Kutukcu E, et al.: Comparison of operative and non operative management of acute appendicitis. Ulus. Trauma. Acil. Cerrahi. Derg. 2009. 15(5): 459-462.
- Barber MD, McLaren J, Rainey JB.: Recurrent appendisitis. Br. J. Surg. 1997. 84: 110-112.
- Kalan M, Talbot D, Culniffe WF, et al.: Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis: a prospective study. Ann. R. Coll. Surg. Eng. 1994. 76(6): 148-419.
- Owen TD, Williams H, Stiff G, st al.: Evaluation of the Alvarado score of acute appendicitis. J. R. Soc. Med. 1992. 85(2): 87-88.
- Brigand C, Steinmetz J-P, Rohr S.: The usefullnes of scores in the diagnosis of appendicitis. Journal de Chirurgie. 2009. 146: 2-7.
- Winn RD, Laura S, Douglas C, et al.: Protocol-based approach to suspected appendicitis, incorporating the Alvarado score and outpatient and antibiotics. ANZ. J Surg. 2004. 74: 324-329.
- Denizbasi A, Unluer EE.: The role of the emergency medicine resident using the Alvarado Score in the diagnosis in acute appendicitis compared with general surgery resident. Eur. J. Emerg. Med. 2003. 10: 296-301.
Downloads
Additional Files
Published
How to Cite
Issue
Section
License
The Faculty of Medical Sciences Journal (RFCM) subscribes to the Open Access policy and does not charge authors fees for publishing, nor does it charge readers fees for accessing published articles (APC).