PT  - JOURNAL ARTICLE
AU  - Fatma K. Althoubaity
TI  - Suspected acute appendicitis in female patients. Trends in diagnosis in emergency department in a University Hospital in Western region of Saudi Arabia
DP  - 2006 Nov 01
TA  - Saudi Medical Journal
PG  - 1667--1673
VI  - 27
IP  - 11
4099  - http://smj.org.sa/content/27/11/1667.short
4100  - http://smj.org.sa/content/27/11/1667.full
SO  - Saudi Med J2006 Nov 01; 27
AB  - OBJECTIVE: To determine the negative appendectomy rate; utilization, accuracy of Alvarado scale, ultrasound (US), computed tomography (CT) in diagnosis of acute appendicitis.METHODS: Hospital records of 124 female patients admitted for suspicious of acute appendicitis from January 2003 - January 2004 to the Emergency Department (ED) at King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia were reviewed retrospectively. We reviewed the age of patients, clinical presentation, Alvarado scale, US, CT, histopathological diagnosis of appendicular specimen.RESULTS: A total of 124 female patients aged 6-64 years were presented to ED with right iliac fossa pain. Of the total, 103 patients have appendectomies (83.1%), 21 (16.9%) patients underwent conservative treatment. Prevalence of advanced appendicitis was 13.7% and negative appendectomy rate was 27.2%. Accuracy rate of appendicitis with Alvarado scale was 67.7%, US was 57.9%, CT was 66.7%. Postoperative complications were found in 2.4%. Positive correlation was found between advanced cases and Alvarado scale (r=0.338), and hospital stay duration (r=0.250, p<0.01).CONCLUSION: Clinical findings and experience remain of major importance in appendicitis-diagnosis. When appendicitis appears with atypical presentations, it remains a clinical challenge. In such cases, laboratory and imaging investigation may be useful in establishing a correct diagnosis. Alvarado scoring system is easy, simple and cheap complementary aid for supporting the diagnosis of acute appendicitis especially for junior surgeons.