EVALUATION OF ACUTE APPENDICITIS ACCORDING TO RIPASA SCORING SYSTEM

Dr. G Naresh; Dr. M Venkata Reddy; Dr. Padmanabh Inamdar

Volume : VIII, Issue : IX, September - 2018

EVALUATION OF ACUTE APPENDICITIS ACCORDING TO RIPASA SCORING SYSTEM

Dr. G Naresh, Dr. M Venkata Reddy, Dr. Padmanabh Inamdar

Abstract :

Introduction:Acute appendicitis is one of the most common surgical emergencies encountered.Even with the diagnostic aids like laboratory examination of blood and urine, ultrasonography, the rate of negative appendectomy is 15 – 25%. Several scoring systems have been introduced to increase the diagnostic accuracy of appendicitis with the Alvarado scoring system being the most popular. However these were developed in the western countries and several studies have shown reduced sensitivity and specificity when applied to a population with a completely different ethnic origin. A new RIPASA scoring system was developed to aid in the diagnosis of acute appendicitis in the Asian countries.The aim of this prospective randomized clinical study is to evaluate this scoring system in our set up.

Patients and methods:The present study was a prospective comparative observational study which consists of 100 patients admitted under General Surgery with Right Iliac Fossa (RIF) pain, with suspected case of appendicitis in Mamata General Hospital. The study was conducted for a period of 24 Months, from October 2015 to September 2017 in the department of General Surgery, Khammam

Observations and results:Appendix was inflamed in 93% of cases where as it was normal in 7%. Out of 7 cases of normal appendix, no pathology was found in 4, and in the rest 3, each of a case of ruptured ovarian cyst, gangrenous Meckel’s diverticulitis and ectopic pregnancy was found. Negative appendectomy rate was 5% in males (3 males), 10% (4 Females) in females and overall was 7%. In the present study, the sensitivity and specificity was 81.72% and 85.71% while positive and negative predictive values were 98.70% and 26.09%, calculated keeping the cut off value of RIPASA score of 7.5.

Conclusion:RIPASA score is very effective in the diagnosis of acute appendicitis in males but some other diagnostic modality may be necessary to ascertain the diagnosis in females along with the clinical scoring system to rule out other pelvic pathology and thereby reducing the higher rates of negative appendectomy in females.