The value of ultrasonography and its' comparison with Alvarado scoring system in acute appendicitis

Abstract

Purpose: The purpose of this study was to assess the diagnostic value of ultrasonography and compare the findings with Alvarado score in acute appendicitis.

Patient and Methods: The clinical and ultrasonographic data of 120 patients who were admitted with suspected appendicitis were collected prospectively. Ultrasonography findings were compared with Alvarado scores according to the histopathological results.

Results: The sensitivity and specificity of USG examination and Alvarado scoring system in the diagnosis of acute appendicitis were 87.7% and 87.20% and 70.4% and 71.8% respectively. USG was more sensitive and specific than Alvarado score in the preoperative evaluation of acute appendicitis but the difference between the results were not statistically significant. When we used USG and clinical scoring together for operation decision, performance of the results showed inverse relationship. In the cases of positive USG and high clinical scores the specificity was 97.4% but the sensitivity was 59.3%. In the cases of positive USG or high clinical score the sensitivity was 98.6% but the specificity was 61.5%.

Conclusion: USG should be done on every patient with suspected appendicitis to decrease negative appendectomy and perforation rates. Patients with score > 6 and positive USG should be operated immediately. Negative USG patients and score <7 could be followed; these patients probably will not need operation. If the score is >6 and USG is negative or the score is <7 but the USG is positive the patients should be closely followed or evaluated with more sensitive or specific imaging tools before deciding on any operation .