Suspected acute appendicitis in female patients. Trends in diagnosis in emergency department in a University Hospital in Western region of Saudi Arabia.
OBJECTIVE
To determine the negative appendectomy rate; utilization, accuracy of Alvarado scale, ultrasound (US), computed tomography (CT) in diagnosis of acute appendicitis.


METHODS
Hospital records of 124 female patients admitted for suspicious of acute appendicitis from January 2003-January 2004 to the Emergency Department (ED) at King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia were reviewed retrospectively. We reviewed the age of patients, clinical presentation, Alvarado scale, US, CT, histopathological diagnosis of appendicular specimen.


RESULTS
A total of 124 female patients aged 6-64 years were presented to ED with right iliac fossa pain. Of the total, 103 patients have appendectomies (83.1%), 21 (16.9%) patients underwent conservative treatment. Prevalence of advanced appendicitis was 13.7% and negative appendectomy rate was 27.2%. Accuracy rate of appendicitis with Alvarado scale was 67.7%, US was 57.9%, CT was 66.7%. Postoperative complications were found in 2.4%. Positive correlation was found between advanced cases and Alvarado scale (r=0.338), and hospital stay duration (r=0.250, p<0.01).


CONCLUSIONS
Clinical findings and experience remain of major importance in appendicitis-diagnosis. When appendicitis appears with atypical presentations, it remains a clinical challenge. In such cases, laboratory and imaging investigation may be useful in establishing a correct diagnosis. Alvarado scoring system is easy, simple and cheap complementary aid for supporting the diagnosis of acute appendicitis especially for junior surgeons.
Althoubaity
Fatma K
FK
Department of Surgery, King Abdul-Aziz University Hospital, PO Box 80215, Jeddah 21589, Kingdom of Saudi Arabia. drfatmasurgery2000@hotmail.com
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology / Q000601:surgery / Q000628:therapy; D001065:Appendix / Q000473:pathology; D002648:Child; D003627:Data Interpretation, Statistical; D003951:Diagnostic Errors; D004636:Emergency Service, Hospital; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D011183:Postoperative Complications; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography