EVALUATION OF HISTOPATHOLOGICAL CORRELATION WITH ALVARADO SCORE IN ACUTE APPENDICITIS

Virendra Kumar Dubey; Dr Shanker Prasad Sinha

Volume : VII, Issue : V, May - 2017

EVALUATION OF HISTOPATHOLOGICAL CORRELATION WITH ALVARADO SCORE IN ACUTE APPENDICITIS

Virendra Kumar Dubey, Dr Shanker Prasad Sinha

Abstract :

Background: Acute appendicitis is one of the most frequent abdominal emergencies, and cannot be diagnosed with 100% accuracy in early stage. Various laboratory and imaging investigations though helpful are not 100% diagnostic. They have to be correlated to history and physical findings to achieve acceptable degree of diagnostic accuracy. Application of Alvarado score is one such method to diagnose acute appendicitis. Material and Methods: This study was carried out to evaluate histopathological correlation with Alvarado score, in 56 patients admitted in the department of surgery. The patients were evaluated for total leucocyte count, clinically and using Alvarado score along with histopathological confirmation for the diagnosis of acute appendicitis. Results: The incidence of acute appendicitis after clinical evaluation using Alvarado score was 23.42% (56) in 205 patients admitted with acute abdominal pain. Pain around the umbilicus shifting to right iliac fossa was the most common clinical symptom (87.5%). The leucocyte count used in Alvarado score showed the sensitivity of 83.67%, specificity of 42.85% with a diagnostic accuracy of acute appendicitis in 78.58% of patients. The histopathological findings confirmed appendicitis in 48 patients with acute appendicitis in 42 (87.50%) and uncomplicated appendicitis in 6 (12.50%) patients. In diagnosis of acute appendicitis, Alvarado score has high sensitivity (95.67%), high specificity (70%) and high diagnostic accuracy (91.08%). Conclusion: The Alvarado score is a non–invasive, safe diagnostic procedure, which is simple fast, reliable and repeatable. It can be used in all condition, without expensive and complicated supportive diagnostic methods. Alvarado score increases the diagnostic certainty of clinical examination in diagnosis of acute appendicitis.