DOI: 10.36347/sjams.2019.v07i07.019

Pages: 2358-2362

Acute appendicitis is an infection of the appendix – the 3 ½-inch-long pouch of tissue attached to the large intestine on the lower right side of the abdomen. This infection and the resulting inflammation can cause symptoms including Pain and Fever. A cross-sectional study was conducted in Rajshahi medical college hospital, Rajshahi to evaluate Sensitivity and Specificity of Modified Alvarado Score in the Treatment of Acute Appendicitis during the period from January 2008 to December 2008. A total of 227 cases having features of appendicitis, admitted in the surgery unit of Rajshahi medical college hospital, were selected for our study. About 221(97.4%) of patients complained sudden onset of anorexia. The second leading symptom was nausea & vomiting 214 (94.3%). About 186 (82%) of the patients had history of onset of pain around umbilicus. Pain shifting to right iliac fossa was complained by 78% of the patients. The affected patients exhibited tenderness in Right lower quadrant (RLQ), positive cough test, muscle guard/rigidity, rebound tenderness, Rovsing’s signs and leukocytosis 220 (96.9%), 215 (94.7%), 215 (94.7%), 210 (92.5%), 206 (90.7%) and 157 (69.2%) were found respectively. The patients with score (8-10) along with history of pain migrating to right iliac fossa and associated with tenderness indicate high possibility of acute appendicitis. While patients with score (1-4) are unlikely to have appendicitis and could be discharged home safely. Modified Alvarado score (8 – 10) along with history of pain migrating to right iliac fossa and tenderness in right lower quadrant indicate high probability of acute appendicitis and should be operated immediately. Patients with score (5 – 7) may have variable outcome and further decisions should be taken according to guidelines of disease. Sensitivity and specificity of Modified Alvarado Score were 94.65% and 80.00% respectively to detect appendicitis in adults.