Evaluation of RIPASA score in the diagnosis of acute appendicitis

Authors

  • Shubhi P. Bhatnagar Department of Surgery, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India
  • Shahaji Chavan Department of Surgery, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20175893

Keywords:

Acute appendicitis, RIPASA score

Abstract

Background: Acute appendicitis is one of the most common surgical emergencies. Despite being a common problem, it remains a difficult diagnosis to establish, particularly among the young, the elderly and females of reproductive age. The study aimed to compare the efficacy of RIPASA score in the diagnosis of acute appendicitis.

Methods: In this cross sectional comparative study, 100 cases of pain in the right iliac fossa were admitted and evaluated clinically. RIPASA score was calculated for all. Ultrasound (USG) of abdomen and pelvis was done. A positive RIPASA score or USG finding was the criteria for open appendicectomy. The postoperative histopathological reports were compared with the RIPASA scores.

Results: RIPASA score was positive in 90% cases. Histopathologically, appendicitis was present in 99% cases. One case of normal appendix histopathologically had a lower RIPASA score. This indicated that RIPASA score could correctly diagnose acute appendicitis in 90% cases.

Conclusions: RIPASA score is an efficient score in the diagnosis of acute appendicitis. As compared with ultrasonography of abdomen and pelvis, the RIPASA score is more diagnostic in cases of acute appendicitis. Negative findings of acute appendicitis on ultrasonography of abdomen and pelvis are not the diagnostic test to rule out appendicitis.

References

Williams GR. Presidential address: A history of appendicitis. Ann Surg. 1983;197:495-506.

Flum DR, Morris A, Koepsell T, Dellinger EP. Has misdiagnosis of appendicitis decreased over time? A population based analysis. JAMA. 2001;286:1748-53.

Petrosyan M, Estrada J, Chan S, Somers S, Yacoub WN, Kelso RL, et al. CT scan in patients with suspected appendicitis: Clinical implications for the acute care surgeon. Eur Surg Res. 2008;40(2):211-9.

Ozao-Choy J, Kim U, Vieux U, Menes TS. Incidental findings on computed tomography scans for acute appendicitis: prevalance, costs and outcome. Am Surg. 2011;77:1502-9.

Karamanakos SN, Sdralis E, Panagiotopoulos S, Kehagias I. Laparoscopy in the emergency setting: a retrospective review of 540 patients with acute abdominal pain. Surg Laparosc Endosc Percutan Tech. 2010 Apr;20(2):119-24.

Chong CF, Adi MIW, Thien A, Suyoi A, Mackie AJ, Tin AS, et al. Development of the RIPASA score: a new appendicitis scoring system for the diagnosis of acute appendicitis. Singapore Med J. 2010;51:220-5.

Regar MK, Choudhary GS, Nogia C, Pipal DK, Agrawal A, Srivastava H. Comparison of Alvarado and RIPASA scoring systems in diagnosis of acute appendicitis and correlation with intraoperative and histopathological findings. Int Surg J. 2017;4:1755-61.

Mohammed A, Shanbhag V, Ashfaque K, SAP. A Comparative Study of RIPASA Score and ALVARADO Score in the Diagnosis of Acute Appendicitis. J of Clinical and Diagnostic Research: JCDR. 2014;8(11):NC03-NC05.

Chong CF, Thien A, Mackie AJA, Tin AS, Tripathi S, Ahmad MA, et al. Comparison of RIPASA and Alvarado scores for the diagnosis of acute appendicitis. Singapore Med J. 2011;52(5):340-5.

Downloads

Published

2017-12-26

Issue

Section

Original Research Articles