Comparative Study between Modified Alvarado Score and Abdominal Ultrasound Diagnostic Value of Acute Appendicitis in Children

Document Type : Original Article


1 Department of Pediatric Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt

2 Department of Radiology, Dameitta Faculty of Medicine, Al-Azhar University, Egypt

3 Department of Vascular Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt

4 Department of Pathology, Damietta Faculty of Medicine, Al-Azhar University, Egypt



Background: Diagnosis of acute appendicitis depends mainly on clinical diagnosis. However, the high negative rate remains a challenge and different aids for diagnosis had been proposed.   
The aim of the work: The current work aimed to assess the sensitivity of Modified Alvarado Score [MAS] in diagnosis of acute appendicitis.
Patients and Methods: One hundred children with clinical manifestations of acute appendicitis were included. Patients were categorized into two groups according to MAS: [group A] included 50 patients with [MAS] ≥ 7 regardless of sonography results. The second group [group B] included another 50 patients with MAS .
Results: Tenderness in right iliac fossa was the most frequent sign in the study population [98%]. Histopathology revealed positive results among 49 patients [47 in group A and 2 in group B] with significant difference between groups A and B. The overall sensitivity and specificity of ultrasonography were 89.4% and 33.3% respectively and were 96.0% and 20.0% respectively of MAS score.
Conclusion: In acute appendicitis, MAS is a good diagnostic [sensitive] tool. Sensitivity increased when combined with ultrasound, as the number of negative appendectomies was reduced.


Main Subjects