Clinical Algorithm for Acute Appendicitis in Reducing Negative Appendectomy Rate (NAR)

Appendicitis is the most common cause of acute surgical abdomen with high negative appendectomy rate (NAR), being diagnosed clinically. RIPASA, ALVARADO scoring system along with imaging modalities have been used for accurate diagnosis. In this study an algorithm is established wherein the imaging modalities along with RIPASA scoring system have been used to arrive at the accurate diagnosis thereby reducing NAR.250 cases of pain in RIF were considered in the study for acute appendicitis. RIPASA and USG in combination were able to diagnose 88 % of the cases with only 2 negative appendectomy, showing high diagnostic accuracy. Cut off value for RIPASA was taken 7