The sensitivity and specificity of the conventional symptoms and signs in making a diagnosis of acute appendicitis

Abstract

Introduction: Simple appendicitis can progress to perforation, which is associated with a much higher morbidity and mortality. So, surgeons have therefore been inclined to operate when the diagnosis is probable rather than wait until it is certain. Objective: This study is designed to evaluate the sensitivity and specificity of clinical examination in the diagnosis of acute appendicitis. Methods: The study included 866 patients of acute appendicitis who had undergone appendicectomy with preoperative diagnosis of acute appendicitis. They were analyzed retrospectively. The parameters evaluated were age/gender, clinical presentation (signs and symptoms) and total white blood cell counts. The operative findings were recorded and the inflammation of the appendix was graded into normal, acutely inflamed and gangrenous. Results: Clinical diagnosis was made correctly in 807 (93.2%) of the patients. White blood cells count ranged from 3.70 to 45.30 /mm 3 (mean 17.5353 /mm 3). It was <10,000/mm 3 in 133 (15.4%) patients. Conclusions: Clinical assessment is the best criterion to reach a confident diagnosis. Investigations may supplement the diagnosis but are never a substitute for it.

The Validity of Alvarado Score in Diagnosis of Acute Appendicitis among Sudanese Patients

“…At cut off point of 3 Alvarado score was found to be accurate rule out score in our study which meet the international report [1]. Fever wasn't found in 43% of positively inflamed appendix, the sensitivity was 63.8 and specificity was 39.2 at [5][6][7][8][9][10] it was not a constant feature of appendicitis.…”

“…Group 1: comprising patients with Alvarado score (1, 2, 3) Group 2: comprising patients with Alvarado score (4,5,6) Group 3: comprising patients with Alvarado score (7,8,9, and 10)…”

“…Approximately 6% of the population will suffer from acute appendicitis during their life time in Sudan it was found to be 63% of overall patients presented as acute abdomen [1][2][3][4][5].…”

The Study of Non Operative Treatment for Acute Appendicitis (NOTA)

“…The present study was designed to evaluate the effectiveness of conservative treatment in the management of uncomplicated acute appendicitis. The mean age in the present study was 25.2±9.7 years (range, 14 to 60) which is in consistent with that reported in literature [1,2,[9][10][11][12].…”

“…Despite technologic advances, the diagnosis of appendicitis is still based primarily on the patient's history and the physical examination. Although most patients with AA can easily be diagnosed, for many of them the signs and symptoms are variable and a firm diagnosis can be difficult [2]. More routine use of imaging has improved diagnostic accuracy and identification of the majority of patients with uncomplicated appendicitis at admission [3].…”