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Objectives: Acute appendicitis remains the commonest intra-abdominalsurgical emergency. This study sought to identify the clinical factors that aremost reliable in the diagnosis of acute appendicitis. Methods: This was aretrospective review of consecutive adult appendicectomies over a 6 monthsperiod. The frequency of different clinical parameters was assessed todetermine the most reliable predictors of acute appendicitis. A simple triad of3 of the most frequent clinical parameters was examined for diagnosticpotential by calculating its sensitivity, specificity, positive predictivevalue and negative predictive value. Results: There were a total of 124patients. The median age was 33 years while the gender distribution was 54males to 70 females. The most common clinical parameters in the patients withappendicitis were right iliac fossa tenderness or peritonism 100.0%, anorexia78.8%, nausea 75.9%, migratory abdominal pain i.e. pain migrating to right lower quadrant 55.7%, tachycardia41.3% and pyrexia i.e. bodytemperature of 37.8 degrees Celsius and above 22.1%. The simple triad ofanorexia, right iliac fossa tenderness and migratory abdominal pain showedspecificity for the diagnosis of acute appendicitis of 84.2% and sensitivity of45.7%. The positive predictive value of this triad was 94.1% while the negativepredictive value was 21.9%. Conclusion: Our study reveals that the positivityfor this simple clinical triad strongly rules in the diagnosis of acuteappendicitis. Its specificity and positive predictive value compares with themost reliable scoring systems for acute appendicitis in literature. Furtherapproaches to diagnosis such as imaging and diagnostic laparoscopy should beconsidered when this triad is negative and appendicitis is suspected. Thissimple diagnostic approach allows for prompt diagnosis and treatment whichexpectedly would improve the morbidity associated with acute appendicitis.

KEYWORDS

Acute Appendicitis, Diagnostic Triad

Cite this paper

Alubaidi, K. , Aikoye, M. and Basnyat, P. 2016 Diagnosis of Acute Appendicitis in Adults: Role of a Simple Clinical Diagnostic Triad. Surgical Science, 7, 191-194. doi: 10.4236-ss.2016.74026.





Autor: Kassem Alubaidi, Malik Aikoye*, P. S. Basnyat

Fuente: http://www.scirp.org/



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