Diagnostic Accuracy of Modified Alvarado Score and Pelvi-Abdominal Ultrasound in Diagnosis of Acute Appendicitis

Abstract

Background: Acute abdominal pain represents about 9% of emergency visits. The likelihood of the diagnosis of surgical etiology increased with the presence of fever, vomiting, diarrhea, absent sounds of bowel, voluntary guarding, abdominal rigidity and rebound tenderness. Patient age could help in the differential diagnosis.

Aim and objectives: To evaluate diagnostic accuracy of modified Alvarado Score and pelvi-abdominal ultrasound in diagnosis of acute appendicitis.

Patients and methods: This prospective observational study, included 50 patients. They were selected from attendee of general surgery clinics, Al-Azhar University Hospitals, Minya-El-Qmah Hospital and Kafr Saqr Hospital, The study completed between September 2023 and March 2024.

Result: There was highly statistically significant positive correlation between pathology with Modified Alvarado score (MAS), while there was statistically significant negative correlation between pathology with sensitivity of ultrasound. MAS had higher sensitivity (87.5%) and specificity (64.7%) than ultrasound for diagnosis of appendicitis.

Conclusion: Modified Alvarado score (87.5% and 64.7%) had higher sensitivity and specificity than ultrasound (81.5% and 62%) for diagnosis of appendicitis. MAS is a good diagnostic tool and both of MAS and Ultrasound whenever available should be used to predict acute appendicitis to increase the number of positive cases and reduce negative appendectomy and hence reduce the morbidity and mortality.