Accuracy of RIPASA Scoring System and Ultrasound in the Diagnosis of Acute Appendicitis: A Comparative Study

Introduction: Acute appendicitis (AA) is a significant health issue that requires fast and accurate diagnosis to avoid complications. Clinical diagnosis remains critical, despite advances in imaging and diagnostic technologies. A variety of scoring systems have been developed to minimize doubt in appendicitis diagnoses. Aside from imaging modalities such as ultrasonography, the RIPASA score is seen to be a more effective diagnostic grading strategy for adults. Material and Methods: A source of 132 cases presented with clinical features suggestive of appendicitis were screened and underwent RIPASA score assessment. Subsequently, all patients underwent ultrasonography to identify characteristics indicative of appendicitis. The accuracy of diagnosing acute appendicitis with the RIPASA score and ultrasound results was linked to the histopathological examination. Results: The comparison of RIPASA score with HPE showed that 66.67% cases who are diagnosed to have appendicitis by RIPASA score are truly had appendicitis by HPE and 5.38% of cases were normal by HPE. The sensitivity, specificity, PPV and NPV of RIPASA score was 86.24%, 63.40%, 89.80%, 47.89% respectively. Whereas for ultrasound, sensitivity, specificity, PPV and NPV of RIPASA score was 73%, 58%, 85.24%, 39.36% respectively. Conclusion: Ultrasonography exhibits low sensitivity and can serve as an adjunctive method for diagnosing appendicitis to exclude alternative etiologies of right iliac fossa pain. The RIPASA score system seems to be an effective instrument for diagnosing acute appendicitis. Consequently, it can be inferred that the RIPASA scoring system is superior, both clinically and statistically, for the evaluation of appendicitis in comparison to ultrasonography.