Acute appendicitis is the most common abdominal surgical emergency in the world with an incidence of 96.5 to 100 per 100,000 adults. The clinical diagnosis is based on history, clinical examination, laboratory evaluation and imaging. In the era of CT scan negative appendectomy has been around 15-25% and considerably higher rate especially in women. In this study we have taken 216 patients of suspected acute appendicitis from the department of surgery during the year 2019-2021. We applied the Modified Alvarado score to these patients. Those patients with a modified Alvarado score >= 8 were taken for the open appendectomy surgery irrespective of ultrasonography \CT findings. Of them 200 patients had Modified Alvarado score above 8. Of which tissue diagnosis was confirmed in 176 patients. Among which we found 112 were male patients and 88 were females. Acute appendicitis was found on h/p reports in 88% of the patients with a score of more than 8. Only 12% of patients were found to have other pathology or normal appendix.
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