Zaffar Iqbal, Zeeshan Saboor Ahmad, Mian Tauseef-ud Din, Mazhar Khan, Nasir Hassan.
Evaluation of Alvarado Score in Detecting Retrocecal Appendicitis.
Ophthalmol Update Jan ;13(3):225-7.

Objective: To evaluate Alvarado score in detecting retrocecal appendicitis Materials & Methods: This was a cross sectional study of 6 months duration, carried out from Jan 2014 to June 2014 in the department of general surgery, Hayatabad Medical Complex, Peshawar. A total of 153 patients were selected and admitted through emergency. Patients were diagnosed using the Alvarado score. Those patients who had a score of more than or equal to 6 were operated. Inclusion and exclusion criteria was set. In this study, the Alvarado score was slightly modified as those patients having superficial tenderness were given 2 marks and those who depicted deep tenderness were given 1 mark. Proforma was made which contain all details of selected patients. Results: A total of 153 patients had an Alvarado score of ? 6 and were operated, out of these 43 patients had a retrocecal appendix and were included in this study. Out of these, 5 patients had an Alvarado score of 8, 11 patients had an Alvarado score of 7 and the remaining 27 had an Alvarado score of 6.Only 2 patients with retrocecal appendicitis presented with migrating right iliac fossa pain. 28 patients had anorexia, 29 patients had nausea or vomiting, 5 patients showed superficial tenderness and the remaining 38 patients had deep tenderness. All the 43 patients showed rebound tenderness, the Bloomberg sign. Just 3 patients had elevated temperature and leucocytosis with shifting to the left was a finding common to 39 patients. Conclusions: Acute retrocecal appendicitis usually lacks the typical clinical features of acute appendicitis as in Alvarado score. This poses a diagnostic challenge for the surgeon and increasing the risk of development of complications in retrocecal appendicitis.

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