Scholarly Article
CORRELATION BETWEEN CLINICAL, RADIOLOGICAL, AND INTRAOPERATIVE FINDINGS IN ACUTE APPENDICITIS: A PROSPECTIVE OBSERVATIONAL STUDY
Jaya Sakthi S, Narendar, Kavin Shivan
2026-07-14 · International Journal of Clinical and Biomedical Research · Sumathi Publications
Abstract
Acute appendicitis is a common surgical emergency whose diagnosis, although fundamentally clinical, is frequently supplemented by imaging. The Modified Alvarado (MANTRELS) score offers a structured, stepwise means of estimating the probability of appendicitis. This study examined the correlation between clinical features, radiological findings, and intraoperative observations in patients with suspected acute appendicitis. This prospective observational study enrolled 25 consecutive patients diagnosed with acute appendicitis who underwent appendicectomy at a tertiary care centre. Demographic and clinical data were recorded, and the Modified Alvarado (MANTRELS) score was assigned preoperatively. Radiological findings were compared with intraoperative findings, and histopathological examination was performed on all specimens. The diagnostic yield of imaging was characterised against operative findings in this single arm operative cohort, and its association with clinical and demographic variables was assessed. The mean age was 36.0 ± 17.0 years, and 72.0% of patients were male. All patients presented with abdominal pain; vomiting was present in 68.0% and fever in 36.0%. A moderate MANTRELS score (5-6) was recorded in 52.0% of patients. Abdominal imaging was suggestive of acute appendicitis in 80.0% of cases. Both intraoperative findings and histopathology confirmed acute appendicitis in all patients, giving a negative appendicectomy rate of 0%. Relative to operative findings, imaging showed a sensitivity of 80.0% and a false-negative rate of 20.0%; because the cohort was uniformly disease-positive, specificity and negative predictive value were not estimable and the positive predictive value (100.0%) reflects the sampling frame rather than test performance in an unselected population. No significant association was found between radiological findings and MANTRELS score category, demographic variables, or clinical features (p > 0.05). In this single-centre prospective correlation study, clinical assessment remained the cornerstone of the diagnosis of acute appendicitis. Radiological imaging was a valuable adjunct, but a negative imaging result did not exclude the diagnosis; clinical judgement should therefore remain paramount, with imaging serving a supportive rather than a substitutive role. Because the cohort comprised only operated, disease-positive patients, these results describe diagnostic yield and clinico-radiological-operative correlation rather than formal diagnostic accuracy, and warrant confirmation in larger, unselected cohorts.
Keywords
Acute appendicitis, Modified Alvarado score, MANTRELS score, Radiological evaluation, Intraoperative findings, Histopathology
Citation Details
International Journal of Clinical and Biomedical Research, Vol. 11, No. 3, pp. 1-8