Journal of the Korean Academy of Family Medicine 1990;11(8):20-30.
Published online August 1, 1990.

급성 충수돌기염의 조기진단을 위한 점수시스템 (Scoring System to Aid Early Dianosis of Acute Appendicitis)

이혜리(Lee Hye Ree),곽기우(Kwak Ki Woo),윤재경(Yoon Jae Kyung),김선규(Kim Sun Kye),백기주(Baek Ki Ju)

연세대학교의과대학 가정의학교실

Abstract

Problems related to the diagnosis of appendicitis are evidenced by the significant negative laparotomy rate. Our present study designed to improve the diagnostic accuracy, and decrease negative appendectomy rate and not increase perforation rate. Total 186 patient who was taken laparotomy under suspected appendicitis were retrospectively reviewed, and identified their history, physical examination and laboratroy findings utilizing 10 predictive factors : migration of abdominal pain, anorexia, nausea, fever, direct tenderness of RLQ, rebound tenderness of RLQ, rectal tenderness, rovsing sign, leukocytosis, shift to left All 9 predictive factors except rectal examination were statistical significance. Using sum of likelihood ratios of these significant 9 factors. scoring sysem was made. The results were following : at not more than 4, appendicitis would not strongly be, and recover by conservative treatment : at 5 throught 12, appendicitis would be only suspected, and indicated for closely observation and if signs and symptoms were progressed, indicated for surgery : at more than 13, appendicitis would be strongly suspected, and indicated for immediate surgery.