Tailoring of computed tomography scanning in patients with acute appendicitis according to combined assessment by Alvarado score and focused ultrasound | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 43, Issue 4, October 2024, Page 1525-1531 PDF (348.16 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/EJSUR.2024.297269.1099 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Mohamed Anan  1; Wael Khafagy2; Mahmoud Abdelnaby1; Ahmed Fadaly Hussien2; Mohamed Farid2
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| 1Department of General Surgery, Mataria General Hospital, Mansoura, Egypt | ||||
| 2Department of General Surgery, Mansoura University Hospitals, Mansoura, Egypt | ||||
| Abstract | ||||
| Background: Deciding for appendectomy based only on the patient’s signs and symptoms results in negative appendectomy in approimately 1/3 of cases. The rationale of this research is to decrease the negative appendectomy as well as complicated appendicitis. Patients and Methods: This is a prospective study on 164 patients presented with acute appendicitis. We included patients of both sexes. Patients were assessed routinely using both the Alvarado score and focused ultrasound (US). Of the patients, 31 showed double positive of both Alvarado score and focused US and were considered as a control group. Computed tomography (CT) scanning was applied to 133 patients who were not double positive. Sensitivities and specificities of all tests were compared with histopathologic examination as a reference standard. Results: CT scanning accuracy in diagnosing acute appendicitis in comparison with pathology results is 100%. Cases with +ve US and –ve Alvarado have an accuracy of 96.4% followed by cases with –ve US and +ve Alvarado, which reaches 94.3% and the least is for double-negative cases (84.4%). Conclusion: The double-check test is a good cheap positive tool and could be used to diagnose true positive cases of acute appendicitis with a sensitivity as that of CT scanning, while CT scanning could be preserved for the negative cases by the double-check test. | ||||
| Keywords | ||||
| Acute appendicitis; negative appendectomy; Alvarado score; focused ultrasound; computed tomography scanning | ||||
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