Reliability of ultrasonography and the Alvarado scoring system in acute appendicitis

Abstract

In this study, we aimed to evaluate the diagnostic performance ofultrasonography, the Alvarado score, mean platelet volume and C-reactiveprotein in the diagnosis of acute appendicitis.Patients admitted to the pediatric emergency department with abdominal painwho were operated on with a preliminary diagnosis of acute appendicitiswere evaluated. The patients who had acute appendicitis diagnosis in thehistopathological assessment were considered as the Appendicitis (App)Group, while patients who did not have acute appendicitis according tohistopathology were considered as the Non-app Group.Of 200 patients assessed in the study, 137 (68.5%) were male and 63 (31.5%)were female. Of the patients operated on; 170 (85%) had acute appendicitis,while the pathological results of 30 (15%) were not consistent with acuteappendicitis. The Alvarado score of the patients in App Group was significantlyhigher than those in Non-app Group (p=0.001). The sensitivity and specificityof the Alvarado score and ultrasonography were 60%, 81.18% and respectively,for the diagnosis of appendicitis. There were no significant differences (p>0.05) in terms of average white blood cell, absolute neutrophil count, plateletcount, mean platelet volume and C-reactive protein between the two groups.According to our study the use of Alvarado Scoring System with ultrasonographyis more effective and accurative than ultrasonography performing alone. Werecommend performing ultrasonography on patients with right lower quadrantpain and suspected appendicitis admitted to the emergency department and tooperate on patients with a ultrasonography-supported appendicitis diagnosisand an Alvarado score of 7 and above. Patients with an appendicitis diagnosisnot supported by ultrasonography and an Alvarado score lower than 7 shouldbe closely monitored.