STUDY OF PRE-OPERATIVE ASSESMENT & INVESTIGATIONS IN DIAGNOSIS OF ACUTE APPENDICITIS

Abstract

BACKGROUND AND OBJECTIVES :

The aim of the study is to find out an preoperative protocol for reducing negative appendicectomy rates. This study also aimed at finding out sensitivity and specificity of Modified Alvarado scoring system, Ultrasound abdomen, C- reactive protein in detecting acute appendicitis.

METHODS :

The study was conducted in a group of 100 cases admitted in Department of General Surgery with suspected appendicitis, who satisfied the inclusion and exclusion criteria. The study involved application of Modified Alvarado scoring system which was applied to all 100 cases. Out of 100 cases, ultrasound examination was done in 70 cases and 50 cases were done with C- reactive protein estimation. At the end of the study, sensitivity, specificity was calculated for Modified Alvarado scoring system, ultrasound examination and C- reactive protein estimation.

RESULTS:

Modified Alvarado score showed sensitivity of 94% , specificity of 76% and positive predictive value of about 93.7%.This study showed ultrasound to have sensitivity of 76%, specificity of 75% and positive predictive value of about 93%.The sensitivity and specificity of C- reactive protein estimation was found to 78% and 66% respectively.

CONCLUSION:

Applying Modified Alvarado scoring system preoperatively as a protocol in patients with suspected appendicitis is useful in reducing negative appendicectomy rates. Ultrasound examination was found to be useful in detecting appendicitis and differentiating other causes of pain abdomen mimicking appendicitis. C- reactive protein estimation is useful in doubtful cases of appendicitis.