Background: Appendicectomy is a very common operation performed. Because of advances in ultrasonography and CT Scanning, there is improvement in the diagnosis of appendicitis, but still, clinical observation and experience of the surgeon matters a lot. Removing normal appendix leads to multiphasic problems. Furthermore, appendix has proved to be a useful structure in reconstructive surgeries.
Aim: This study evaluates the validation of the Anderson score for
diagnosis of acute appendicitis by histopathology.
Methods: This prospective observational study was performed in the
Surgery Department at SGT Medical College, Gurugram, Haryana. The study
included a total of 100 patients. Informed consent was taken for examination
and investigations giving due respect to maintain the patient’s privacy and
keep them comfortable. A detailed history was taken, clinical examination and
investigations were done. All patients were subjected to Anderson's score.
Appendix was sent for Histopathology examination. Sensitivity, specificity,
positive predictive value and negative predictive values were found out.
Statistical analysis was carried out using statistical SPSS version 23 software
by using the Chi-square test.
Results: In 70 patients, Anderson score was >8, which was in
favor of acute appendicitis. It means these patients should require surgery. In
30 patients score was <8. The sensitivity, specificity, positive predictive
value and overall accuracy of clinical examination have been found to be 63.2%,
81.8%, 62.2% and 70.8% respectively. The most common histopathology finding was
acute appendicitis then diffuse suppurative appendicitis followed by gangrenous
appendicitis still followed by diffuse suppurative appendicitis with peri
appendicitis.
Conclusions: The study found out that if Anderson's score is ≥8,
appendicectomy should be done. But if Anderson's score is 0-4, the patient
should be managed conservatively, if the score is 5-8, the final decision will
depend on further investigations, observations and a second opinion.
Author (s) Details
Kanwar Singh Goel
Department of General Surgery, SGT Medical College, Budhera, Gurugram,
Haryana, India.
Sapna Goel
Department of Pathology, Shaheed Hasan Khan Mewati Government Medical
College, Nuh, Haryana, India.
Nikhil Goel
Department of Psychiatry, Shaheed Hasan Khan Mewati Government Medical
College, Nuh, Haryana, India.
Tarun Aggarwal
Department of General Surgery, SGT Medical College, Budhera, Gurugram,
Haryana, India.
Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v12/2871
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