impact of sonography and Alvarado score on the clinical management of patients with acute appendicitis

ABSTRACT

Purpose: To determine whether diagnosis by graded compression ultrasonography improves clinical outcome for patients with suspected acute appendicitis. Material and A total of 180 patients suspected to have acute appendicitis were included in the study. 90 patients were randomized to the intervention group and were subjected to a diagnostic protocol incorporating ultrasonography and the Alvarado score. A control group included 90 patients in whom the standard clinical management was applied. The appendix was visualized at US in 69 of 83 patients [83%]. Sensitivity, specificity and accuracy of ultrasound in the diagnosis of acute appendicitis were measured at 92%, 90% and 91% respectively. Patients in the intervention group had a statistically significant lower number of both non-therapeutic operations and perforated appendix. There was no statistically significant difference in between groups in the total number of operations performed. Graded compression sonography is a powerful imaging tool that substantially improves diagnostic accuracy in patients with clinically equivocal appendicitis