EFFICACY OF MODIFIED ALVARDO SCORE AND DIAGNOSTIC LAPAROSCOPY IN DECREASING NEGATIVE APPENDICECTOMY RATE IN FEMALES OF CHILD BEARING AGE GROUP (15�45 YEARS).

Dr. Puneet Agrawal; Dr. Ajay Agrawal

Volume : VII, Issue : II, February - 2017

EFFICACY OF MODIFIED ALVARDO SCORE AND DIAGNOSTIC LAPAROSCOPY IN DECREASING NEGATIVE APPENDICECTOMY RATE IN FEMALES OF CHILD BEARING AGE GROUP (15�45 YEARS).

Dr. Puneet Agrawal, Dr. Ajay Agrawal

Abstract :

Two hundred female patients, attending general surgery OPD and emergency department w.e.f October 2014 till October 2016 with complaint of pain in abdomen were included in this study. One main complaint of all these patients was pain in right lower abdomen. All these patients were scored by modified Alvardo score. If the score is less than 4 then conservative treatment was given. In equivocal modified Alvardo score (5&6) further evaluation by radiological method was done. If modified Alvardo score was more than 7 then definitive treatment, that is appendicectomy or diagnostic laparoscopy was done. All the specimens were sent for histopathological examination. In females, negative appendicedomy rate is more because of varied pathology in lower abdomen such as uretric colic, UTI, torsion of ovarian cyst, pelvic inflammatory disease, salpingitis, acute gastroenteritis, ruptured ectopic pregnancy etc. Hence, to decrease negative appendicectomy rate in females we have used modified Alvardo score and diagnostic laparoscopy to confirm the diagnosis of acute appendicitis. Conclusions – 1. In female patients of reproductive age group high index of suspicion should be taken in account to consider possibility of acute appendicitis. 2. Diagnostic laparoscopy is the confirmatory investigation to diagnose right lower quadrant pain and to diagnose other gynecological problems.