- Hipokrat Tıp Dergisi
- Vol: 3 Issue: 2
- Accuracy in the diagnosis of acute appendicitis: Physical examination versus imaging
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 : 23 | Download : 43
Publication Date : 2023-08-21
Article Type : Research Article
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 (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 (p=0.000). The Alvarado score was found to be the most useful parameter in making the surgery decision (p<0.001). In the regression model in which only Alvarado parameters were included, the most critical parameters in predicting acute appendicitis were fever (p<0.001), leukocytosis (p=0.001), rebound (p=0.016) and migration of pain to the right lower quadrant (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 (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