Comparision of ultrasonographic diagnosis with ‘Tzanakis’ Score in acute appendicitis

Abstract

Introduction: Acute appendicitis is one of the most common acute surgical abdominalconditions requiring surgery. Ever since the inflamed appendix was demonstrated in the 1980’sby Ultrasonography, it has been used as an aid to clinically diagnose acute appendicitis. Tzanakisscoring system is a combination of clinical examination, Ultrasonography and inflammatory markers.Methods: A retrospective non-randomized observational study was conducted from April 2014 toMarch 2015 on all cases of acute appendicitis, which underwent preoperative ultrasound beforeappendectomy (open/laparoscopic) at the Department of surgery, Nepal Medical College TeachingHospital. Ultrasound findings and Tzanaki score were compared in the cases. No studies could befound in literature comparing ultrasound diagnosis with Tzanaki score in appendicitis.Results: The sensitivity, specificity, positive predictive value and negative predictive value ofultrasound were 73%, 50%, 95% and 12% respectively. The sensitivity, specificity, positive predictivevalue and negative predictive value of Tzanaki were 87%, 50%, 96% and 23% respectively. Tzanakiscore is better than ultrasound alone as a diagnostic test for acute appendicitis.Conclusion: Tzanaki score is better than ultrasound in diagnosis of acute appendicitis.Key Words: Appendicitis; Tzanakis score; ultrasonography.