A Comparative study of Ripasa Score and Ultrasound in the Diagnosis of Acute Appendicitis

BACKGROUND: Acute appendicitis is one of the most common acute abdominal surgical emergencies; the diagnosis of which is often challenging. If there is a delay in the diagnosis and prompt action is not taken, it may lead to perforation and other complication. Many scoring systems have been devised for the diagnosis of appendicitis, among which Modified Alvarado score is being used widely. Ultrasound also has gained importance in recent years. Our study aims is to evaluate the use of RIPASA score and USG in the diagnosis to bring down the rate of negative appendicectomies. OBJECTIVE: To evaluate the sensitivity, specificity, positive predictive value and negative predictive value of RIPASA scoring system and ultrasound in the diagnosis of acute appendicitis and to reduce the rate of negative appendicectomy. MATERIAL AND METHODS: Design: Cross sectional study. This study was done in 100 patients admitted in Government Royapettah Hospital for a period of 6months. Patients were evaluated using RIPASA scoring and USG. Decision for surgery was made independent of the score and USG findings. Diagnosis was confirmed by intraoperative and histopathological findings. Results were confirmed by chi-square test. A negative appendicectomy was considered when a non- inflamed appendix was removed. RESULTS: In our study, out of the 100 patients who were operated, 80 patient had appendicitis and 20 were normal according to intraoperative and histopathological findings. RIPASA score (> 7.5) had a sensitivity and specificity of 81.25 and 60 % respectively. USG had a sensitivity of 73.75% and a specificity of 55%. CONCLUSION: In this study RIPASA scoring system showed a better diagnostic accuracy than USG in the diagnosis acute appendicitis and in reducing the negative appendicectomy rate