Diagnosis of Acute Appendicitis in Sub-Saharan Africa

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Résumé

Objective: The aim of our study was to propose a solution for rationalizing
requests for ultrasound examination and CT scan in suspected acute appendi
citis, based on use of the Alvarado score. Patients and Methods: We included
in our study all patients consulting for pain of the right iliac fossa, whatever
their age and sex, who had been diagnosed with acute appendicitis and who
had undergone appendectomy. We used the Alvarado scoring system, based
on clinical items and laboratory measurements, to diagnose appendicitis. Re
sults: One hundred eleven patients, of whom 77 were men (69.4%) and 34
were women (30.6%), with a sex ratio of 2:2.6, were included. Mean age was
31.29 ± 1.31 years, with a range of 1 to 81 years. The diagnosis of definite ap
pendicitis was established in 54 patients (48.6%). Abdominal ultrasound ex
amination had been performed in 80 patients (72.1%). It established a diagno
sis of appendicitis in 69 patients (86.2%), while in 11 patients (13.8%) the ap
pendix was described as normal or was not visualized. Conclusion: Our study
demonstrated good agreement between preoperative diagnosis and the result
of the Alvarado score applied a posteriori. Ultrasound was not always con
tributory to the diagnosis of acute appendicitis. It could be reserved for pa
tients whose clinical and laboratory score indicated that appendicitis was
unlikely.

Mots-clés

Acute Appendicitis, Diagnosis, Ultrasound Examination, Burkina Faso, Alvarado Score