Rasool Bux Behan, Jarwar M K, Prem Kumar, Ikramdin Ujjan, Saeeda Mamon, Imran Ali Sheikh, Muhammad Farooq.
Diagnostic accuracy of alvarado scoring system in the management of acute appendicitis.
Pak J Med Health Sci Jan ;4(4):501-3.

Objective: To determine the diagnostic accuracy of Alvarado Scoring System in the management of acute appendicitis. Study design: This study was carried out in department of surgery LUMHS, Jamshoro, Hyderabad from January, 2007 to December, 2008.A total of 227 patients were included in this study. Patients were assigned Alvarado scoring system and divided into three groups. Group 1:(Score l-4)Immediate discharge and advise for follow-up. Group 2:(Score 5-7)Observational group. Group 3:(Score 8- 10) Immediate appendectomy. Result: Out of 227 patient, 108(47.6%) patients presented with migratory pain, 44(19.4%) presented with pain right iliac fossa, 21(9.2%) with pain in whole abdomen and 54(23.8%) with pain in para umbilical region. Out of 227 patients, 33(14.53%) had avarado score 1-4 and all patients discharged with advise for follow up and 3 patients readmitted and required surgical intervention. 49(21-59%) patients had inflamed score 5 and out of 49, 37 patients required surgical intervention and 12 patients discharge after 24 hours. 61(26.87%) had score 6-7 and all patients required surgical intervention. 84(37.1%)patients had score 8-10 and all underwent surgery. Out of 227 patients, 185 underwent surgery. Out of 227, 185 patients underwent surgery and out of these,145(78.06%) patients had acute inflammatory appendix and in 35(18.9%) patients, 18-94% appendix was found normal, 5(2.5%) patients having ruptured ovarian cyst, mesenteric cyst, lymph adenitis and meckles diverticulum. Specimen of‘ 147 patients, out of 185 operated, were submitted for histopathology. The normal appendix was found in 27(18.4%) patients and inflamed appendix was found in 120(81.6%) patients. Conclusion: Alvarado scoring system is reliable, cheap, quick and handy tool in emergency department and in rural area, this system is helpful in diagnosis/ management of acute appendicitis.

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