Ohmann Score versus Modified Alvarado Score for Diagnosis of Acute Appendicitis

INTRODUCTION Acute inflammation of the vermiform appendix, a blind-ended tubular structure present at the convergence of the taenia coli arising from the cecum, denotes acute appendicitis [1]. It is one of the most common causes of acute abdomen, with a lifetime risk of developing the condition being 6.7% in females and 8.6% in males [2]. Early and accurate diagnosis is the cornerstone in the management of this condition to prevent morbidity and mortality [3,4]. Patients usually present with a sudden onset of pain in the peri-umbilical region, which then shifts to the right iliac fossa (RIF) and is associated with anorexia, nausea, vomiting, and fever. Tenderness and rebound tenderness elicited over the RIF is a vital clinical clue for its diagnosis. However, these typical findings are found in only 50–60% of cases, making early and accurate diagnosis of acute appendicitis challenging. Inaccurate diagnosis results in negative appendectomy rates ranging from 2-30%, whereas delayed surgical intervention can lead to perforation and peritonitis rates as high as 20% [2,3,5,6]. Imaging modalities like ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) have high sensitivity and specificity for the evaluation of patients with suspected acute appendicitis, but issues of availability, cost, and time raise questions about their application [2,5,7].