APPENDICECTOMY

MODIFIED ALVARADO SCORING SYSTEM; DOES IT HELP TO AVOID UNWANTED OPERATION?

Abstract

Introduction: Several diagnostic aids have been developed to
improve diagnosis in suspected appendicitis and to avoid negative appendicectomy. Objectives: To
evaluate modified, Alvarado scoring system in reducing rate of negative appendicectomy. Study Design: A
prospective study was conducted. Setting: Jinnah hospital Lahore. Period: January 2003 to July 2003.
Patients & Methods: 96 patients admitted with suspected diagnosis of appendicitis but with equivocal
signs were management according to modified Alvarado system. Results: Diagnosis of acute appendicitis
was made in 61 patients on the basis of scoring system. These patients were operated for appendicitis.
Vermiform appendix was found to be acutely inflamed in all but 5 patients, giving a negative
appendicectomy rate of 8.2%. A clinical decision to operate leads to removal of a normal appendix in 15%
to 30% of cases. Conclusions: Modified Alvarado’s scoring system did well in reducing negative
appendicectomy rate. It is not meant to replace clinical judgment, and is not considered a primary mean of
making a diagnosis of acute appendicitis.