To evaluate outcome of combined modified RIPASA scoring and ltrasonography to improve diagnostic accuracy in acute appendicitis

Abstract

Background: Acute appendicitis a surgical emergencies is still a difficult diagnosis to make, especially in young persons, the elderly, and in reproductive-age women. Different scoring systems have been created to increase diagnostic accuracy based on clinical history and intial lab parameters. Objectives: This study was done to prospectively evaluate the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score for the diagnosis of acute appendicitis in patients presenting to the Accident and Emergency department or the Surgical wards with right iliac fossa pain. Methods: A prospective study was conducted in MVJ MC & RH on symptomatic patients presented with complaints of right iliac fossa pain. Clinical history and examination, radiological record and histopathologic reports were noted. We studied accuracy modified RIPASA score with Ultrasound and Histopathological reports in evaluation the diagnosis of acute appendicitis. Results: In our study we noted Sensitivity, specificity and diagnostic accuracy of modified RIPASA score was 89.5%, 66.7% and 88.3% respectively. Sensitivity, specificity and diagnostic accuracy of USG was 70.2%, 67% and 70%respectively. On combining modified RIPASA score with USG, Sensitivity, specificity and diagnostic accuracy were 98.2%, 66.7% and 96.7% respectively. Conclusion: On adding USG with modified RIPASA score there is increase in sensitivity and diagnostic accuracy. So modified RIPASA score with USG can be used in patient with RIF pain for making diagnosis of acute appendicitis.

Keywords

• acute appendicitis
• appendicectomy
• ripasa score