RESUMO
Morbidity in children treated with right iliac fossa pain results either from late diagnosis or negative appendectomy. Diagnosis in equivocal cases is difficult. A prospective analysis of the Alvarado score for early diagnosis of appendicitis and to avoid unnecessary admissions for all patients with right iliac fossa pain was conducted. 255 patients with right iliac fossa pain from age 3 to 12 were enrolled in this prospective study in a period of 2 years. Patients were categorized into three groups according to the Alvarado score. Group 1 patients [63] with the Alvarado score 1 to 4 were discharged but reviewed in OPD, group 2 [139] with the Alvarado score 5 to 6 were kept under observation and group 3 [53] with Alvarado score 7 to 9 were operated. Of the discharged patients 9 were admitted due to worsening of symptoms. 3/9 were operated. 2/3 were diagnosed as appendicitis. Patients under observation, 12/139 [8.6%] underwent appendectomy, 10/12 were found to have appendicitis. All of group 3 patients were operated. 49/53 [92.4%] were found to have acute appendicitis. As a whole only 68/255 [26.6%] patients were operated, 61/68 were diagnosed as appendicitis on histopathology. Negative appendectomy rate fell on 10.2%. Sensitivity of score >/= 7 to diagnose appendicitis was 92.4%. The Alvarado score is simple, easy and reliable to decide whether to discharge, observe or operate the patients who visit emergency department with right iliac fossa pain