Combined Use of Modified Alvarado Scoring System and Ultrasound in the Diagnosis of Acute Appendicitis –A Study

Background: Acute appendicitis is one of the most common acute abdominal surgical emergencies; the diagnosis of which is often challenging. If there is a delay in the diagnosis and prompt action is not taken, it may lead to perforation and other complications. Scoring systems have been devised like the Modified Alvarado score [MAS]. Ultrasound {USG} also has gained importance in recent years. This study aims in combining the use of Modified Alvarado score and USG in the diagnosis of acute appendicitis to bring down the rate of negative appendicectomies. Methods: This prospective observational analytical study was done in 100 patients admitted in mallareddy narayana multispeciality hospital from 2022 to 2024 with appendicitis. Patients were evaluated using mas and usg. Decision for surgery was made independent of the score and USG findings. The diagnosis was confirmed by intraoperative and histopathological findings. Results were analyzed by chi-square test. A negative appendicectomy was considered when a noninflamed appendix was removed. Results: In our study, out of the 100 patients who were operated, 94 patients had appendicitis and 6 were normal according to intraoperative and histopathological findings. Modified Alvarado score (>7) had a sensitivity of 97.67%.USG had a sensitivity of 61% and a specificity of 83.3%. Both combined together had a sensitivity of 31.9% only. Conclusion: The use of MAS and USG in the diagnosis of acute appendicitis have a good statistical correlation but with combined, the sensitivity is less.