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2015 | 87 | 2 | 65-70
Tytuł artykułu

The Value of Scoring Systems for the Diagnosis of Acute Appendicitis

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Accurate diagnosis of acute appendicitis (AA) is still a problem and is not always easy, even for experienced surgeons. Studies have shown that 20 to 30% of the appendices removedwere normal. Therefore, various scoring systems have been developed to aid in the diagnosis of doubtful cases and reduce the number of unnecessary appendectomies. The aim of this study was to assess the diagnostic value of different scoring systems in acute appendicitis. Material and methods. The study involved 94 patients who underwent laparotomy due to suspected acute appendicitis. Medical examination at hospital admission was performed by a resident and a general surgery specialist. The probability of AA was evaluated using six different scoring systems: Alvarado, Fenyo, Eskelinen, Ohman, Tzankis, and RIPASA. The resident calculated the results in individual systems. The decision to perform the operation was taken by a specialist surgeon who did not know the results. Results. Normal appendix was removed in 26% of cases. Eskelinen, RIPASA and Alvarado systems showed highest sensitivity (99%, 88% and 85%, respectively). Tzankis and Fenyo systems showed highest specificity (62% and 50%, respectively). Conclusions. Our study has shown limited value of scoring systems for the diagnosis of acute appendicitis. The systems may improve diagnostic accuracy as they require obtaining a more detailed medical history, and making a more thorough and organized data analysis. However, the scoring systems should be treated only as an aid to diagnosis
Wydawca
Rocznik
Tom
87
Numer
2
Strony
65-70
Opis fizyczny
Daty
wydano
2015-02-01
online
2015-07-03
Twórcy
  • Department of General Surgery, John Paul II Memorial Hospital in Bełchatów1 Ordynator: lek. P. W. Trzeciak / Department of Experimental Surgery, Medical University in Łódź2 Kierownik: dr hab. Z. Pasieka, prof. nadzw. , dominikwalczak@gmail.com
  • Department of Experimental Surgery, Medical University in Łódź2 Kierownik: dr hab. Z. Pasieka, prof. nadzw.
  • Department of Spatial Econometrics, Faculty of Economics and Sociology, University in Łódź3 Kierownik: prof. dr hab. J. Suchecka
  • Department of General Surgery, John Paul II Memorial Hospital in Bełchatów1 Ordynator: lek. P. W. Trzeciak
  • Department of General Surgery, John Paul II Memorial Hospital in Bełchatów Ordynator: lek. P. W. Trzeciak
  • Department of General Surgery, John Paul II Memorial Hospital in Bełchatów Ordynator: lek. P. W. Trzeciak
  • Department of General Surgery, John Paul II Memorial Hospital in Bełchatów Ordynator: lek. P. W. Trzeciak
  • Department of General Surgery, John Paul II Memorial Hospital in Bełchatów Ordynator: lek. P. W. Trzeciak
  • Department of Experimental Surgery, Medical University in Łódź2 Kierownik: dr hab. Z. Pasieka, prof. nadzw.
Bibliografia
  • 1. Horzić M, Salamon A, Kopljar M et al.: Analysis of scores in diagnosis of acute appendicitis in women. Coll Antropol 2005; 1: 133-38.
  • 2. Andersen E, Sondenaa K, Soreide JA et al.: Acute appendicitis. Preoperative observation time and diagnostic accuracy. Tidsskr Nor Laegeforen 1992; 112: 630-34.
  • 3. Białas M, Gryszkiewicz M: Podejrzenie ostrego zapalenia wyrostka robaczkowego - trudności w rozpoznaniu i metody wspomagające diagnostykę. Nowiny Lekarskie 2006; 75: 184-92.
  • 4. Blomqvist PG, Andersson RE , Granath F et al.: Mortality After Appendectomy in Sweden, Ann Surg 1987-1996; 233: 455-60.
  • 5. Alvarado A: A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986; 15: 557-64.
  • 6. Ohmann C, Franke C, Yang Q et al.: Diagnostic score for acute appendicitis. Chirurg 1995; 66: 135-41.
  • 7. Van Way CW 3rd, Murphy JR, Dunn EL et al.: A feasibility study of computer aided diagnosis in appendicitis. Surg Gynecol Obstet 1982; 155: 685-88.
  • 8. Eskelinen M, Ikonen J, Lipponen P: A computerbased diagnostic score to aid in diagnosis of acute appendicitis: a prospective study of 1333 patients with acute abdominal pain. Theor Surg 1992; 7: 86-90.
  • 9. Tzanakis NE , Efstathiou SP: A new approach to accurate diagnosis of acute appendicitis World J Surg 2005; 29: 1151-56.
  • 10. Chong CF , Thien A, Mackie AJA et al.: Comparison of RIPASA and Alvarado scores for the diagnosis of acute appendicitis. Singapore Med J 2011; 52: 340-44.
  • 11. Fenyo G: Routine use of a scoring system for decision making in a suspected acute appendicitis in adults. Acta Chir Scand 1987; 153: 545-57.
  • 12. Thuijls G, Derikx JP, Prakken FJ et al.: A pilot study on potential new plasma markers for diagnosis of acute appendicitis. Am J Emerg Med 2011; 29: 256-60.
  • 13. Farooqui W, Pommergaard HC, Burcharth J et al.: The diagnostic value of panel of serological markers in acute appendicitis. Scand J Surg 2014 Apr 15. (Epub ahead of print)
  • 14. Andersson M, Rubér M, Ekerfelt C et al.: Can new inflammatory markers improve the diagnosis of acute appendicitis? World J Surg 2014; 38: 2777-83.
  • 15. Schuler JG, Shortsleeve MJ, Goldenson RS et al.: Is there a role for abdominal computed tomographic scans in appendicitis? Arch Surg 1998; 133: 373-76.
  • 16. Rao PM, Rhea JT, Rattner DW et al.: Introduction of appendiceal CT: impact on negative appendectomy and appendiceal perforation rates. Ann Surg 1999; 229: 344-49.
  • 17. Jones K, Pena AA , Dunn EL et al.: Are negative appendectomies still acceptable? Am J Surg 2004; 188: 748-54.
  • 18. McDonald GP, Pendarvis DP , Wilmoth R et al.: Influence of preoperative computed tomography on patients undergoing appendectomy. Am. Surg 2001; 67: 1017-21.
  • 19. Pinto F, Pinto A, Russo A et al.: Accuracy of ultrasonography in the diagnosis of acute appendicitis in adult patients: review of the literature. Crit Ultrasound J 2013; 5: S2.
  • 20. Ohle R, O’Reilly F, O’Brien KK et al.: The Alvarado score for predicting acute appendicitis: a systematic review. BMC Med 2011; 9: 139.
  • 21. Hugh TB, Hugh TH: Appendectomy - becoming a rare event. http: //karmak.org/archive/2003/05/ hugh.html
  • 22. Phillips AW, Jones AE , Sargen K: Should the macroscopically normal appendix be removed during laparoscopy for acute right iliac fossa pain when no other explanatory pathology is found? Surg Laparosc Endosc Percutan Tech 2009; 19: 392-96.
  • 23. Hamminga JT, Hofker HS, Broens PM et al.: Evaluation of the appendix during diagnostic laparoscopy, the laparoscopic appendicitis score: a pilot study. Surg Endosc 2013; 27: 1594-1600.
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_1515_pjs-2015-0021
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