A Comparison between Alvarado and RIPASA Scoring Systems in Diagnosis of Acute Appendicitis


Background: Acute appendicitis presents surgeons with a diagnostic dilemma due to a large range of differential diagnoses and, in certain cases, unusual presentation. The most prevalent modality of diagnosis, sonography, has a very low specificity and sensitivity. It puts a surgeon in a difficult situation, especially in an emergency. In acute appendicitis, incorporating clinical scoring into the diagnostic process has been proven to improve decision-making and lower the rate of negative appendectomy. Methods: The purpose of this prospective observational study was to determine the efficacy of the Alvarado and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) ratings in the pre-operative diagnosis of acute appendicitis, as well as the relationship between these scores and histopathological diagnosis. The study included 100 patients that met the inclusion and exclusion criteria. A detailed history and a thorough clinical examination led to the diagnosis of acute appendicitis. For identifying acute appendicitis, the RIPASA score was found to have a higher sensitivity. Negative appendectomy rates were 11.5 and 19.2 percent for the RIPASA and Alvarado scoring systems, respectively, but

Conclusions: Clinical scoring provides a non-invasive, repeatable, and safe diagnostic approach for acute appendicitis that is quick, straightforward, and inexpensive. According to this study, RIPASA is a better grading method for diagnosing acute appendicitis than Alvarado.

Author (s) Details

Dr. (Lt Col) Ankur Varma
Department of Surgery, 151 Base Hospital, Guwahati, India.

Dr. (Maj) Aditi Varma
Department of Radiodiagnosis, 151 Base Hospital, Guwahati, India.

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