Sonographic and histopathological correlation of Alvarado score in the diagnosis of acute appendicitis in Mid-western region of Nepal.

Aim: To evaluate the sonographic and histopathological correlation of Alvarado scoring system in the diagnosis of acute appendicitis. Materials and Methods: A retrospective search of the pathological database was performed for cases operated with a diagnosis of acute appendicitis. Inclusion criteria included a) patient age > 11 years of age b) no previous similar symptoms in the past c) no past surgical history within a period of 6 months d) cases with Alvarado scoring. Cases with incomplete clinico-radiological information and those treated prior to admission were excluded. Results: Of the total 362 cases, majority were males (54.69 %). The sensitivity of ultrasound in diagnosing acute appendicitis in patients with Alvarado score > 7 was 96.67 % which decreased to 79.14 % in those with a score of ? 7. The overall negative appendectomy rate was 11.87 %. Conclusion: Alvarado score in conjunction with ultrasound is significant in decreasing the negative appendectomy rate in acute appendicitis.