Background: Deciding for appendectomy based only on the patient's signs and symptoms results in negative
appendectomy in approimately 1/3 of cases. The rationale of this research is to decrease the negative appendectomy as
well as complicated appendicitis.
Patients and Methods: This is a prospective study on 164 patients presented with acute appendicitis. We included
patients of both sexes. Patients were assessed routinely using both the Alvarado score and focused ultrasound (US).
Of the patients, 31 showed double positive of both Alvarado score and focused US and were considered as a control
group. Computed tomography (CT) scanning was applied to 133 patients who were not double positive. Sensitivities and
specificities of all tests were compared with histopathologic examination as a reference standard.
Results: CT scanning accuracy in diagnosing acute appendicitis in comparison with pathology results is 100%. Cases
with +ve US and –ve Alvarado have an accuracy of 96.4% followed by cases with –ve US and +ve Alvarado, which
reaches 94.3% and the least is for double-negative cases (84.4%).
Conclusion: The double-check test is a good cheap positive tool and could be used to diagnose true positive cases of
acute appendicitis with a sensitivity as that of CT scanning, while CT scanning could be preserved for the negative cases
by the double-check test.