Diagnostic scales for acute appendicitis in atypical and rare forms

Abstract

Traditional diagnosis of acute appendicitis (AA) leads to an increase in the number of «negative» appendectomy
(35-40%) or delayed operations (25-30%), since there are no symptoms and laboratory tests strictly specific
for AA. The presence of inflammation in the appendix (IA) in atypical and rare forms of AA (up to 30%), in
children, in women of childbearing age and pregnant women in the 2nd-3rd trimester, in the elderly over
60 years of age, are manifested by various clinical variants of the course of the disease, which often do not
require surgical intervention. To improve the diagnosis of OA in these cases, the use of diagnostic scales of
acute appendicitis allows. Their meaning lies in the selection of the most objective and informative parameters,
each of which is assigned a certain number of points; taking into account the sum of the points scored, the
question of the tactics of managing a patient with suspected AA is decided. Among them, A. Alvarado (1986)
DSHA is the most informative, easy to use, does not require special equipment and tools. If AA is suspected, it
can be used equally successfully in all hospitals of the emergency medical service.