THE ROLE OF THE ALVARADO INTEGRAL SCALE IN THE DIAGNOSIS OF ATYPICAL AND RARE FORMS OF ACUTE APPENDICITIS

Abstract

The traditional diagnostics of acute appendicitis (AA) leads to an increased number of "negative" appendectomies (35-40%) or delayed operations (25-30%), as there are no strictly specific symptoms and laboratory tests for AA. The presence of inflammation in the appendix in atypical and rare forms of AA (up to 30%), in children, in women of fertile age, and in pregnant women in the 2nd or 3rd trimester, or the elderly (over 60 years of age) develop a variety of clinical variants of the disease course, which often do not require surgical intervention. In these cases, the use of diagnostic scales of acute appendicitis helps to improve diagnosis of AA. Their meaning lies in the selection of the most objective and informative parameters, each of them being assigned a certain number of points; the question about the tactics of management of a patient with a suspected AA is decided on the basis of the sum of the points. A.Alvarado diagnostic score (1986) is the most informative among them, easy to use, and does not require special equipment. When AA is suspected, it can be applied equally successfully in any in-patient emergency medical services.