Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
World Journal of Emergency Surgery
Published in: World Journal of Emergency Surgery 1/2016

Open Access 01-12-2016 | Review

How to improve the clinical diagnosis of acute appendicitis in resource limited settings

Author: Alfredo Alvarado

Published in: World Journal of Emergency Surgery | Issue 1/2016

Login to get access

Abstract

This article is a general review of the diagnostic tools that the clinician can use for the early diagnosis of acute appendicitis with emphasis on the Alvarado Score, and it is aimed principally to the medical practitioners in different parts of the world where the diagnostic facilities and technological resources are limited.
Literature
1.
Lewis FR, Holcroft JW, Boey J, et al. Appendicitis: a critical review of diagnosis and treatment in 1000 cases. Arch Surg. 1975;110:677–84.CrossRefPubMed
2.
3.
Langenscheidt P, Puschel W, Feifel G. High rates of appendectomy in a developing country: an attempt to contribute to a more rational use of surgical resources. Eur J Surg. 1999;165(3):248–5.CrossRefPubMed
4.
McFee AS, Rogers W. Diagnostic appendicitis in the pediatric patient. Ann Emerg Med. 1982;42–9.
5.
Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15(5):557–64.CrossRefPubMed
6.
Moustafa MH, Newton E. Letter to JAMA. Feb 26 1997-Vol 277, No. 8
7.
8.
Ebell MH, Shinholser JA. What are the most clinically useful cutoffs for the Alvarado and pediatric appendicitis scores? A systematic review. Ann Emerg Med. 2014;64(4):365–72.CrossRefPubMed
9.
Borgstein PJ, Gordijn RV, Eijsbouts QA, Cuesta MA. Acute appendicitis—a clear cut case in men, a guessing game in young women. A prospective study on the role of laparoscopy. Surg Endosc. 1997;11(9):923–7.CrossRefPubMed
10.
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(5):1594–600.CrossRefPubMed
11.
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(1):52.
12.
Reich B, Zalut T, Weiner S. An international evaluation of ultrasound vs. computed tomography in the diagnosis of appendicitis. Int J Emerg Med. 2011;4:68.CrossRefPubMedPubMedCentral
13.
Chiang DT, Tan EI, Birks D. To have or not to have. Should computed tomography and ultrasonography be implemented as a routine work-up for patients with suspected appendicitis in a regional hospital? Ann R Coll Surg Engl. 2008;90(1):17–21.CrossRefPubMedPubMedCentral
14.
John H, Neff U, Kelemen N. Appendicitis diagnosis today: Clinical and ultrasound deductions. World J Surg. 1993;17:243–9.CrossRefPubMed
15.
Mettler FA et al. Effective doses in radiology and diagnostic nuclear medicine: A catalog. Radiology. 2008;24(1):254–63.CrossRef
16.
Guite KM, Hinshaw LH, Ranallo FN, et al. Ionizing radiation in abdominal CT: unindicated multiphase scans are an important source of medically unnecessary exposure. J Am Coll Radiol. 2011;8:756–61.CrossRefPubMedPubMedCentral
17.
Hong JJ, Cohn SM, Ekeh P, et al. A prospective randomized study of clinical assessment versus computed tomography for the diagnosis of acute appendicitis. Surg Infect. 2003;4(3):231–9.CrossRef
18.
Petrosyan M, Estrada J, Chan S, et al. CT scan in patients with suspected appendicitis: clinical implications for the acute care surgeon. Eur Surg Res. 2008;40(2):211–9.CrossRefPubMed
19.
Lee SL, Walsh AJ, Ho HS. Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of appendicitis. Arch Surg. 2001;136(5):556–62.CrossRefPubMed
20.
McKay R, Shepherd J. The use of the clinical score system by Alvarado in the decision to perform computed tomography for acute appendicitis in the ED. Am J Emerg Med. 2007;25(50):489–93.CrossRefPubMed
21.
Tan WJ, Acharyya S, Goh YC, et al. Prospective comparison of the Alvarado score and CT scan in the evaluation of suspected appendicitis: a proposed algorithm to guide CT use. Am Coll Surg. 2015;220:218–24.CrossRef
22.
Inci E, Hocaoglu E, Aydin S, et al. Efficiency of unenhanced MRI in the diagnosis of acute appendicitis: comparison with Alvarado scoring system and histopathological results. Eur J Radiol. 2011;80(2):253–8.CrossRefPubMed
23.
Winn RD, Laura S, Douglas C, Davidson P, Gani JS. Protocol-based approach to suspected appendicitis, incorporating the Alvarado score and outpatient antibiotics. ANZ J Surg. 2004;74(5):324–9.CrossRefPubMed
24.
Di Saverio S, Sibilo A, Giorgini E, et al. The NOTA study (non-operative treatment for acute appendicitis). Ann Surg. 2014;269:109–17.CrossRef
25.
Salminem P, Paajanem H, Rautio T, et al. Antibiotic therapy vs appendectomy for treatment of uncomplicated acute appendicitis. JAMA. 2015;313(23):2340.CrossRef
26.
Rocha LL, Rossi FM, Pessoa CM, et al. Antibiotics alone versus appendectomy to treat uncomplicated acute appendicitis in adults: what does meta-analysis say? World J Emerg Surg. 2015;10:51.CrossRefPubMedPubMedCentral
Metadata
Title
How to improve the clinical diagnosis of acute appendicitis in resource limited settings
Author
Alfredo Alvarado
Publication date
01-12-2016
Publisher
BioMed Central
Published in
World Journal of Emergency Surgery / Issue 1/2016
Electronic ISSN: 1749-7922
DOI
https://doi.org/10.1186/s13017-016-0071-8

Other articles of this Issue 1/2016

World Journal of Emergency Surgery 1/2016 Go to the issue

Research article

Implementation of a quality improvement project on smoking cessation reduces smoking in a high risk trauma patient population

Research article

Emergency General Surgery: evolution of a subspecialty by stealth

Research article

Geriatric Assessment as a qualification element for elective and emergency cholecystectomy in older patients

Review

Focus on the prophylaxis, epidemiology and therapy of methicillin-resistant Staphylococcus aureus surgical site infections and a position paper on associated risk factors: the perspective of an Italian group of surgeons

Research article

Damage control operations in non-trauma patients: defining criteria for the staged rapid source control laparotomy in emergency general surgery

Research article

Retrospective one-million-subject fixed-cohort survey of utilization of emergency departments due to traumatic causes in Taiwan, 2001–2010