Comparative study between clinical and paraclinical diagnosis in patients with acute appendicitis

Introduction: This study aims to provide a comparative evaluation of the clinical and paraclinical diagnosis in patients with acute appendicitis. Methods: After investigation, the cases of 200 patients with symptoms of acute appendicitis who had referred to Shahid Beheshti Hospital of Yasuj-Iran in 2018 year and underwent surgery were examined. Variables of age and sex, pathology results, ultrasonography results and clinical signs were examined. Results: The mean age of the patients was 24.3 years (range of 4-80 year). The majority of patients were in 16- 30 years. The most common symptoms were anorexia and abdominal tenderness. 126 (63%) patients had a Modified Alvarado Score (MAS) 4-6 and 74 (37%) of the patients had higher than 7. (91%) patients had positive pathology for appendicitis. The results showed that there was a statistically significant relationship (P=0.03) between MAS and pathology results. There is no statistically significant relationship (P=0.43) between MAS and ultrasound. There is a statistically significant relationship(P=0.0001) between pathology results and ultrasonography results. the sensitivity of ultrasonography was 37.1%, specificity 87.2%, positive predictive value 96.8% and negative predictive value 11.7%. Conclusion: There is a significant statistical relationship between the results of pathology and the MAS. There is not significant statistical relationship between the results of ultrasound and the Modified Alvarado Score in the diagnosis of acute appendicitis. The sensitivity of ultrasonography in the diagnosis of acute appendicitis is low, and may not be suitable method to diagnose acute appendicitis.