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Appendicitis-II: Diagnostic Studies and Management01:29

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
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Acute appendicitis - new diagnostic algorithm using RIPASA score and non-contrast Computeed Tomography Scan.

George Neelankavil Davis1, Maithreyi Swaminathan1

  • 1Nevill Hall Hospital, Brecon Road, Abergavenny NP7 7EG.

JPMA. the Journal of the Pakistan Medical Association
|January 31, 2019
PubMed
Summary

Non-contrast computed tomography (CT) scan and the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score demonstrated the highest accuracy in diagnosing appendicitis. These methods outperformed the modified Alvarado score and ultrasound in this comparative study.

Keywords:
Appendicitis, RIPASA, Diagnosis, Algorithm

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Area of Science:

  • Medical Imaging
  • Surgical Diagnostics
  • Gastroenterology

Background:

  • Appendicitis diagnosis relies on clinical scores and imaging.
  • Comparing diagnostic accuracy of various methods is crucial for effective patient management.

Purpose of the Study:

  • To compare the diagnostic accuracy of RIPASA and modified Alvarado scores against non-contrast CT and ultrasound for appendicitis.

Main Methods:

  • Observational correlational study involving 206 patients with right lower quadrant pain.
  • Data collected on modified Alvarado, RIPASA scores, ultrasound, and non-contrast CT.
  • Laparoscopic appendectomy and histopathological analysis confirmed diagnoses.

Main Results:

  • RIPASA score achieved 92.72% diagnostic accuracy; modified Alvarado score achieved 59.22%.
  • Ultrasound showed high sensitivity (94.65%) but low specificity (5.26%).
  • Non-contrast CT scan demonstrated 100% diagnostic accuracy.

Conclusions:

  • Non-contrast CT scan and RIPASA score are the most accurate diagnostic modalities for appendicitis.
  • These findings support the utility of RIPASA score and non-contrast CT in appendicitis diagnosis.