Comparative Evaluation of the Clinical and Paraclinical Diagnosis in Patients with Acute Appendicitis

Aims: Acute appendicitis is the most common emergency surgery; thus, its diagnosis requires high accuracy. This study aimed to determine the agreement between clinical and paraclinical diagnoses in patients with acute appendicitis. Instrument & Methods: This descriptive study was performed on patients referred to Shahid Beheshti Hospital in Yasouj with suspicion of acute appendicitis in ۲۰۱۸. After considering the inclusion criteria, the files of ۲۰۰ patients were included in the study by purposive sampling. Age, sex, main problem, symptoms, clinical signs, white blood cell count, and ultrasonography and pathology report were extracted from the patients' files, and the Modified Alvarado Score was calculated based on their information. Findings: The mean age of the patients was ۲۴.۳±۱۳.۲ years, and the most common symptoms were anorexia and abdominal tenderness. The Modified Alvarado Score was  ۴-۶ in ۱۲۶ (۶۳%) and ۷ or higher (۳۷%) in ۷۴ patients. In addition, ۱۸۲ patients (۹۱%) had a positive pathology for appendicitis. There was a statistically significant relationship (p=۰.۰۳) between Modified Alvarado Score and pathology; however, there was no statistically significant relationship (p=۰.۴۳) between Modified Alvarado Score and ultrasonography. There was a significant relationship (p=۰.۰۰۰۱) between pathology and ultrasonography. The ultrasonography sensitivity was ۳۷.۱%, specificity was ۸۷.۲%, positive predictive value was ۹۶.۸%, and negative predictive value was ۱۱.۷%. Conclusion: There is an agreement between the Modified Alvarado Score and ultrasonography in diagnosing acute appendicitis with the pathology as the gold standard in the diagnosis of appendicitis; however, there is no agreement between the Modified Alvarado Score and ultrasonography.

Keywords:

Appendicitis , Pathology , Ultrasonography