Accuracy in the diagnosis of acute appendicitis: Physical examination versus imaging

Authors : Suat BENEK, Sami AÇAR

Pages : 41-47

Doi:10.58961/hmj.1274156

View : 32 | Download : 50

Publication Date : 2023-08-21

Article Type : Research Paper

Abstract :Abstract Background Acute appendicitis is one of the most common causes of acute abdomen. In case of delay in the diagnosis process, perforation develops, and the patient\`s morbidity and mortality increase. In our study, we evaluated the effectiveness of laboratory, radiological, and physical examination findings in diagnosing acute appendicitis. Methods A total of 488 patients hospitalized with a prediagnosis of acute appendicitis were included in the study. 162 patients constituted the unoperated and 326 patients constituted the operated group insert ignore into journalissuearticles values(Groups 1 and 2);. The two groups were compared in terms of age, gender, and ultrasonographic findings, as well as Alvarado score parameters. Results In logistic regression analysis, which included only Alvarado parameters, anorexia was the most valuable parameter in predicting surgery insert ignore into journalissuearticles values(p=0.000);. The Alvarado score was found to be the most useful parameter in making the surgery decision insert ignore into journalissuearticles values(p<0.001);. In the regression model in which only Alvarado parameters were included, the most critical parameters in predicting acute appendicitis were fever insert ignore into journalissuearticles values(p<0.001);, leukocytosis insert ignore into journalissuearticles values(p=0.001);, rebound insert ignore into journalissuearticles values(p=0.016); and migration of pain to the right lower quadrant insert ignore into journalissuearticles values(p=0.04);. When the Alvarado score was compared with other parameters in group 2, ultrasonographic positivity was at least as predictive as Alvarado positivity. While 87% of operated women had appendicitis, 94.3% of men had appendicitis insert ignore into journalissuearticles values(Chi-square p=0.02);. Conclusion The clinic of the patient is more important than the laboratory and radiological findings in making the surgery decision in patients consulted with a preliminary diagnosis of acute appendicitis. Using the Alvarado scoring system at this stage will reduce negative appendectomy rates.
Keywords : Akut apandisit, Alvarado skoru, Ultrasonografi, Fizik muayene