Role of Alvarado Scoring System as a Diagnostic Aid in Preoperative Diagnosis of Acute Appendicitis

Background and Aim: Alvarado scoring system is one of them and is purely based on history, clinical examination and few laboratory tests and is very easy to apply. Present study was done is to evaluate the role of Alvarado Scoring System (MANTRELS Scoring) in preoperative diagnosis of acute appendicitis. Material and Methods: This study was carried out on 100 patients who are having pain in right Iliac Fossa region and these patients were admitted in Department of General Surgery, in our hospital for further evaluation and management. Evaluation of these patients will be done by Alvarado Score and Ultrasonography. Patients were divided in 3 groups: 1) Cases with score of 1-4 were observed and not operated. 2) Cases with score of 5-6 were observed for next 24 hours for revision of scoring. 3) A Patients with score of 7-10 who are considered candidates for appendectomy were assessed again after ultrasonography. The reliability of Alvarado scoring system is assessed by calculating Negative appendicectomy rate and Positive predictive value. Results: There were 70 males and 30 females included in the study. The age range of included patients was found to be 8 to 55 years. Out of 100 cases, 14 patients had a score of <5. Out of them, 6 patients seemed to have an inflamed Appendix and 4 patients seemed to have a normal Appendix intraoperatively. On histopathological examination, it was proved that out of these 48 cases, 32 actually had acute appendicitis, 12 patients had chronic appendicitis while the remaining 4 had a normal Appendix. Conclusion: Alvarado scoring System is a fast, simple, cost-effective, reliable, non-invasive, repeatable, and safe diagnostic method for acute appendicitis without complications.