ABSTRACT
Decision making in cases of acute appendicitis may be difficult specially for junior surgeons. Radiological investigations do not appear to be helpful. In some studies, the Alvarado scoring system was helpful in minimizing unnecessary appendicectomies. The aim of this study was to evaluate Alvarado score and its combined use with graded compression ultrasonography in the diagnosis of cases suspected to have acute appendicitis. All patients who were admitted with a provisional diagnosis of acute appendicitis between [first of May 2004 to the last of April 2005], in Surgical Emergency Department Alexandria Main University Hospital were prospectively entered into this study. The study included 377patients between the ages of 10 and 76 years. They were prospectively evaluated on admission using the Alvarado Score to determine whether or not they had acute appendicitis all equivocal cases were subjected to graded compression ultrasonogra