A comparative study of clinical, radiological and operative findings in acute appendicits

Abstract

Background- Acute appendicits is most common cause of an ‘acute abdomen’ in young adults and as such the associated symptoms and signs have become a paradigm for clinical teaching. Though extraordinary advances in modern diagnostic investigations have been achieved, the diagnosis of acute appendicitis remains essentially clinical, requiring a mixture of observation, clinical acumen and surgical knowledge. Objectives- To assess the association between clinical, radiological and operative findings and thus evaluate clinical diagnostic accuracy and radiological diagnostic accuracy. Materials And Methods- It is a prospective study, conducted in a group of 400 cases admitted with suspected appendicitis to Department of General Surgery, KIMS Hospital, Bangalore after satisfying inclusion and exclusion criterias. The study involved application of modified Alvarado scoring system for clinical diagnosis and ultrasound examination for radiological diagnosis, at the end of study, sensitivity, specificity was calculated for Modified Alvarado scoring system and ultrasound examination. Results- Appendicitis more commonly found in 3rd decade (42%) followed 4thdecade (23.7%). Appendicitis is more common in males (61%) against females (39%) clinical diagnosis by using Modified Alvarado score has sensitivity of 94, specificity 34 in diagnosing acute appendicitis. Radiological diagnosis by USG has sensitivity 80, specifificity 68, in diagnosing acute appendicitis.