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Abstract

Objectives: To review the demographics and clinical course of admitted patients with possible acute appendicitis (AA), determine the Alvarado score of operated patients and correlate with histopathology results, correlate the Alvarado score and ancillary procedure results, describe the alternative diagnoses of patients initially considered to have AA and to determine the negative appendectomy rate. Design: It is a retrospective & descriptive study. Setting: St. Luke�s Medical Center, Philippines, a tertiary, private institution. Participants: 82 admitted pediatric patients from the ER (January 2012 to June 2013), assessed using the Alvarado score and suspected to have AA were included. Patients with imaging confirmed diagnosis or those who were already treated conservatively upon arrival at the ER, patients with incomplete documentation or who were discharged against medical advice were excluded. Main Outcome Measure: Histopathology findings among post-appendectomy patients and alternative diagnoses among those who were not operated on. Results: There was a significant difference in the number of patients with scores 1-4, 5-6, and 7-10 with and without appendicitis, thus a significant correlation between the Alvarado score and the diagnosis of AA existed. Among patients with AA, there is an increasing trend of making accurate diagnosis with an increasing score group. Conversely, an opposite trend is observed among those without AA. The negative appendectomy rate was 10.6%. Conclusion: The Alvarado scoring system is a practical non-invasive diagnostic procedure that is simple, fast, safe and reliable. It categorizes patients for discharge and for admission for further evaluation and management. Patients with score 7-10 should undergo appendectomy to avoid complications. Patients with score 5-6 should be admitted for observation and further evaluation. Score 1-4 can be discharged with an advice to seek consult as indicated.

Biography

Ingrid G Malaluan has completed her BS in Biology from the University of the Philippines in 2005. She has completed her Doctor of Medicine at the University Of Santo Tomas Philippines in 2009 and her Internship training at the UST Hospital. She has completed her Pediatric Residency training at St. Luke’s Medical Center- Quezon City, Philippines in 2013 and became the Chief Resident of the Department of Pediatrics in 2014.

Email: dr.ingridgmalaluan@yahoo.com