Syed Arsalan Haider Bukhari, Shabbir Hussain Rana.
Alvarado Score: A new approach to Acute Appendicitis.
Pak Armed Forces Med J Jan ;52(1):47-50.

Acute appendicitis is unequivocally, the most common surgical emergency one comes across daily surgical experience. Simple and straight forward in its offering and accompanying history, sometimes it baffles the attending surgeon to such a compass, that he either banks on observing the patient for further developments or decides to go in for exploration. Alvarado scoring system, is therefore one of the attempts in this regard so as to ensure a precise or a near precise, diagnosis of appendicitis. A planned study was conducted at CMH Bahawalpur, from June 2000 to June 2001. Initially 286 cases were included in the study, but later 11 female patients were excluded, because they developed florid signs of pelvic inflammatory disease, which were also validated sonologically. Anorexia, shift of pain to right iliac fossa and rebound tenderness, was found the most unwavering features in majority of cases. Scores of 4 or above were selected for appendectomy. 255 patients underwent appendectomy. All but the perforated or gangrenous appendices were subjected for histopathology. 15 operated cases were found to be having normal appendices. 20 patients were treated conservatively because their scores were less than 4 according to Alvarado`s tabulation. These patients were observed for further clinical developments.

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