Diagnostic accuracy of alvarado score and trans-abdominal ultrasonography in diagnosing acute appendicitis in Dodoma,Tanzania
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Date
2022
Authors
Journal Title
Journal ISSN
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Publisher
The University of Dodoma
Abstract
Background: Appendicitis is the commonest disease accounting for several consultations at the general surgical clinic and emergency department. Its diagnosis depends on clinical presentation and confirmation by imaging studies including trans-abdominal ultrasound which is readily available and affordable in most health facilities.
Objective: This study aimed at evaluating the diagnostic accuracy of transabdominal ultrasound and Alvarado score in acute appendicitis in Dodoma, Tanzania from March 2019 to March 2022.
Methodology: This was a cross-sectional hospital-based study that involved patients who were operated on for acute appendicitis. Clinical diagnosis of appendicitis was accomplished by the Alvarado scoring system and trans-abdominal ultrasound (TAUS) was used to confirm a preoperative diagnosis. Appendiceal biopsies were taken to pathologists for confirmation. Obtained data were filled and analyzed by SPSS version 26. The receiver operating characteristics (ROC) curve obtained diagnostic accuracy of the Alvarado score and TAUS.
Results: During the study, about 18 (25.4%) were aged < 20 years, with a mean age of 34.8±14.6 The majority were female 47 (66.2%). Also, TAUS was observed to have a sensitivity of 48.3%, specificity of 58.8%, a positive predictive value (PPV) of 56.8%, a negative predictive value of 50%, and diagnostic accuracy of 44% while the Alvarado score was found to have a sensitivity of 75.9%, specificity of 55.9%, PPV of 47.7%, NPV of 37.4% and diagnostic accuracy of 60% in diagnosing appendicitis.
Conclusion and recommendation: The diagnosis of acute appendicitis is still challenging in a clinical setting. Intensive clinical assessment of patients and the proper use of graded compression technique in diagnostic sonographic imaging can help to improve the diagnostic accuracy of both the Alvarado score and transabdominal ultrasound in diagnosing acute appendicitis.
Description
Dissertation (MSc Medicine in General Surgery)
Keywords
Appendicitis, surgical clinic, Ultrasound, Alvarado score, Trans-abdominal ultrasound, Abdominal ultrasound, Acute appendicitis, Sonographic, Dodoma, Tanzania
Citation
Mbaga,S. (2022). Diagnostic accuracy of alvarado score and trans-abdominal ultrasonography in diagnosing acute appendicitis in Dodoma,Tanzania (Master's dissertation). The university of Dodoma, Dodoma.