EVALUATING CLINICAL ALVARADO SCORING SYSTEM AND CT CRITERIA IN THE DIAGNOSIS OF ACUTE APPENDICITIS

M SOHAIL; H ZAIDI; O AAMIR

doi:10.54112/bcsrj.v2023i1.378

Authors

M SOHAIL Department of Radiology, CMH Malir, Pakistan
H ZAIDI Department of Radiology, CMH Malir, Pakistan
O AAMIR Department of Radiology, CMH Malir, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.378

Keywords:

Acute Appendicitis, Clinical Alvarado Scoring System, CT Scan

Abstract

The retrospective study was conducted in Combined Military Hospital from January 2021- January 2022 to assess the diagnostic value of CT and the clinical Alvarado scoring system for patients with acute appendicitis. A total of 200 participants were included in the study. Patient details were recorded, including demographic data, radiological findings, Alvarado clinical assessment scoring, and pathological findings. CT evaluation was based on the diameter of the Appendix, presence or absence of appendicolith, peri appendiceal inflammation, and free fluid. Results showed that there was a significant association between CT criteria (free fluid, peri appendiceal inflammation, and appendicolith) and the presence of appendicitis (P=.01). There also was a significant association between Alvarado score and appendicle diameter (P=.01), and also between WBC and appendicle diameter (P=.01). The cut-off value obtained for appendicle diameter was 6.4 mm. Computed tomography is an accurate modality for diagnosing acute appendicitis. CT and Alvarado score systems provide helpful insight for diagnostic workup of suspected cases of acute appendicitis.

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References

Bastiaenen, V. P., Allema, W. M., Klaver, C. E., van Dieren, S., Koens, L., Tanis, P. J., and Bemelman, W. A. (2020). Routine histopathologic examination of the Appendix after appendectomy for presumed appendicitis: Is it really necessary? A systematic review and meta-analysis. Surgery 168, 305-312.

Bom, W., Bolmers, M., Gans, S., van Rossem, C., van Geloven, A., Bossuyt, P., Stoker, J., and Boermeester, M. (2021a). Discriminating complicated from uncomplicated appendicitis by ultrasound imaging, computed tomography or magnetic resonance imaging: systematic review and meta-analysis of diagnostic accuracy. BJS open 5, zraa030.

Bom, W. J., Scheijmans, J. C., Salminen, P., and Boermeester, M. A. (2021b). Diagnosis of uncomplicated and complicated appendicitis in adults. Scandinavian Journal of Surgery 110, 170-179.

Castro, B. A., Novillo, I. C., Vázquez, A. G., Garcia, P. Y., Herrero, E. F., and Fraile, A. G. (2019). Impact of the appendiceal position on the diagnosis and treatment of pediatric appendicitis. Revista Paulista de Pediatria 37, 161-165.

Di Buono, G., Maienza, E., Buscemi, S., Randisi, B., Romano, G., and Agrusa, A. (2020). Acute appendicitis in a patient with situs viscerum inversus totalis: role of laparoscopic approach. A case report and brief literature review. International Journal of Surgery Case Reports 77, S29-S33.

El Hattabi, K., Bouali, M., El Berni, Y., Bensardi, F., El Bakouri, A., Moufakkir, A., Riad, N., and Fadil, A. (2022). Value of Alvarado scoring system in diagnosis of acute appendicitis. Annals of Medicine and Surgery 77, 103642.

Gonullu, E., Bayhan, Z., Capoglu, R., Mantoglu, B., Kamburoglu, B., Harmantepe, T., Altıntoprak, F., and Erkorkmaz, U. (2022). Diagnostic accuracy rates of appendicitis scoring systems for the stratified age groups. Emergency Medicine International 2022.

Iabichino, G., Di Leo, M., Arena, M., Passoni, G. G. R., Morandi, E., Turpini, F., Viaggi, P., Luigiano, C., and De Luca, L. (2022). Diagnosis, treatment, and current concepts in the endoscopic management of gastroenteropancreatic neuroendocrine neoplasms. World Journal of Gastroenterology 28, 4943.

Kadi, M., Nasr, A., Shabkah, A. A., Alnahari, R., Alhawi, A., Alyamani, R., and Saleem, A. M. (2022). Histopathological examination of cases with acute appendicitis, A retrospective study at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Annals of Medicine and Surgery 81, 104401.

Kang, H. J., Kang, H., Kim, B., Chae, M. S., Ha, Y. R., Oh, S. B., and Ahn, J. H. (2019). Evaluation of the diagnostic performance of a decision tree model in suspected acute appendicitis with equivocal preoperative computed tomography findings compared with Alvarado, Eskelinen, and adult appendicitis scores: A STARD compliant article. Medicine 98.

Kim, I., Kwon, H., Choi, Y. J., Kwak, Y. H., Lee, J. H., Suh, D., Jung, J. Y., and Park, J. W. (2020). Computed tomography scan usage when US results are non-diagnostic for suspected acute appendicitis in children. Medicine 99.

Lau, H. T., Liu, W., Lam, V., and Pang, T. (2022). Early routine (erCT) versus selective computed tomography (sCT) for acute abdominal pain: A systematic review and meta-analysis of randomised trials. International Journal of Surgery 101, 106622.

Talabi, A. O., Adedeji, T. A., Sowande, O. A., and Adejuyigbe, O. (2021). Predictive values of Alvarado score, serum C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis: a prospective study. Annals of Pediatric Surgery 17, 1-7.

Tatar, I. G., Yilmaz, K. B., Sahin, A., Aydin, H., Akinci, M., and Hekimoglu, B. Research Article Evaluation of Clinical Alvarado Scoring System and CT Criteria in the Diagnosis of Acute Appendicitis.

Williams, J., Butchy, M., Lau, L., Debski, N., Williamson, J., Knapp, K., Katz, D., Moront, M., and Lindholm, E. B. (2023). Pediatric Appendicitis Transfers From Adult Centers: Can Alvarado Scores Help Determine Which Patients Need a CT? The American Surgeon, 00031348231157838.