A STUDY OF DIAGNOSTIC VALUES OF RIPASA SCORING SYSTEM AND ULTRASONOGRAPHY IN ACUTE APPENDICITIS
Main Article Content
Keywords
RIPASA score, Ultrasonography, acute appendicitis, histopathology
Abstract
Background: Acute appendicitis (AA) poses a significant health risk, necessitating timely and accurate diagnosis to prevent complications. Despite advancements in imaging and diagnostic techniques, the clinical diagnosis remains pivotal. Various scoring systems, including RIPASA, have emerged to support diagnosis, alongside imaging modalities like ultrasonography (USG). This study systematically evaluates and compares the diagnostic accuracy of the RIPASA scoring system with USG in the clinical diagnosis of acute appendicitis.
Methods: A prospective study involving 100 patients with acute abdominal pain and a provisional diagnosis of acute appendicitis was conducted over one year. The RIPASA scoring system was utilized, and diagnoses were confirmed through histopathological examination (HPE), serving as the gold standard. Data were analyzed using IBM SPSS Statistics (2015), computing sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Inclusion criteria encompassed right iliac fossa pain, provisional AA diagnosis, willingness for surgery, and study consent. Exclusion criteria included appendicular mass or abscess and generalized peritonitis. Sampling utilized a purposive approach with convenience sampling, and ethical considerations were observed.
Results: Ultrasonography findings revealed various appendiceal abnormalities in 59 out of 100 patients. The tripartite comparison (RIPASA, USG, and HPE) demonstrated that RIPASA outperformed USG, exhibiting higher sensitivity (0.82 vs. 0.75), specificity (0.57 vs. 0.42), accuracy (0.79 vs. 0.71), PPV (0.92 vs. 0.86), and NPV (0.35 vs. 0.24). The bipartite comparison further underscored RIPASA's superiority across all metrics.
CONCLUSION:
RIPASA scoring is a good indicator of the severity of acute appendicitis and helps is guiding better prognosis.
References
2. Kalan, M., Talbot, D., Cunliffe, W.J., Rich, A. (1994). Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis: a prospective study. Ann. R. Coll. Surg. Engl., 76(6), 418.
3. Ohle, R., O’Reilly, F., O’Brien, K.K., Fahey, T., Dimitrov, B.D. (2011). The Alvarado score for predicting acute appendicitis: a systematic review. BMC Med, 9(1), 1–3.
4. Al-Hashemy, A.M., Seleem, M.I. (2004). Appraisal of the modified Alvarado score for acute appendicitis in adults. Saudi Med. J., 25(9), 1229–1231.
5. Khan, I., ur Rehman, A. (2005). Application of Alvarado scoring system in the diagnosis of acute appendicitis. J. Ayub Med. Coll. Abbottabad, 17(3).
6. Ozkan, S., Duman, A., Durukan, P., Yildirim, A., Ozbakan, O. (2014). The accuracy rate of Alvarado score, ultrasonography, and computerized tomography scan in the diagnosis of acute appendicitis in our center. Niger. J. Clin. Pract., 17(4), 413–418.
7. Bhattacharjee, P.K., Chowdhury, T., Roy, D. (2002). Prospective evaluation of modified Alvarado score for the diagnosis of acute appendicitis. J. Indian Med. Assoc., 100(5), 310–311.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Ramya.M
Surgery resident, Department of General Surgery, SVMCH&RC, Pondicherry
Gowthaman.M.D
Assistant professor, Department of General Surgery, SVMCH&RC, Pondicherry
Selvakumar K
Professor and Head of the Department, Department of General Surgery, SVMCH&RC, Pondicherry
Indrajit Anandakannan
Assistant professor, Department of General Surgery,Sri venkateshwaraa medical college hospital and research centre (SVMCH& RC), Pondicherry.Phone (or Mobile) No.: +91-9486752808
Lochan Thanigachalam
Surgery resident, Department of General Surgery, SVMCH&RC, Pondicherry