ACCURACY OF CLINICAL DIAGNOSIS IN ACUTE APPENDICITIS

Abstract

INTRODUCTION: Acute appendicitis is the most common abdominal emergency. The lifetime risk of developing appendicitis he is approximately 7% and is usually required surgical treatment. The clinical diagnosis may be straight forward in patients who present with classical signs and symptoms, atypical presentations may result in Diagnostic confusion and delay in treatment. The delay in early diagnosis lead to disease prognosis, which lead to increase in morbidity of the patient. MATERIALS AND METHODS: The study was conducted in department of surgery, Maharajah's Institute Of Medical Sciences, during the period of 1vyear. All patients operated for appendicectomy during that period were included. All the patients complete clinical history and physical examination data were collected. All patients data with operative and discharge record were correlated with the case notes wherever necessary RESULTS: Even in the most experienced the hands the diagnosis of appendicitis can be challenging, and is predominantly a clinical one. Accurate clinical history and physical examination are important to prevent unnecessary surgery and avoid complications. Probability of appendicitis depends on age, clinical settings and symptoms. Application of Alvarado scoring system in diagnosis of appendicitis can provide high degree of positive predictive value and thus diagnostic accuracy. CONCLUSION: No symptom or sign maybe ascribed to acute appendicitis as patognomonic. Acute appendicitis in emergency setting may be successfully rolled in with high accuracy based on lack of appetite, elevated WBC count. For successful diagnosis through assessment that contains adequate evaluation of laboratory parameters in combination with clinical and radiological ndings.