Protective role of vitamin B12 on acetic acid induced colitis in rats.

Objectives: Inflammatory bowel disease (IBD) is a chronic, relapsing, and remittent inflammatory disease of the gastrointestinal tract. Nutritional deficiency may be instrumental in and attributable to this disease. We examined the effect of VitB12 supplementation on acetic acid (AA)-induced colitis in rats. Material and Methods: Five minutes after the application of acetic acid to the rats to create a colitis model, VitB12 was administered 1 mg/kg, i.p concentration, then the application continued for three consecutive days. Control groups were included for colitis and VitB12. After 4d, the rats were sacrificed, and colonic tissues were harvested for macroscopic and microscopic examination of colonic damage. TNF-α, IL-1ß, IL-6, MDA, GSH and SOD values were measured biochemically. Results: There was statistically significant macroscopic improvement in damage to the colon tissues (p <0.05). The severity of inflammation reduced in the VitB12 treated rat group compared with the control group, but was not significantly. The levels of TNF-α, IL-1ß, MDA, and SOD did not differ between AA control and VitB12 treated AA colitis group. However, the levels of IL-6 and GSH were statistically significant different in rats with AA-induced colitis after VitB12 injection (p <0.05). Conclusion: Nutritional deficiencies might contribute to the pathogenesis of IBD, and the efficacy of VitB12 supplementation has controversial effects on the intestinal mucosa.

Associations between postoperative analgesic consumption and distress tolerance, anxiety, depression, and pain catastrophizing: a prospective observational study

Abstract Background Patients' postoperative treatment might be affected by their psychological state. The study aimed to evaluate the effects of anxiety, coping ability (stress tolerance), depression, and pain catastrophizing on analgesic consumption in patients scheduled for sleeve gastrectomy. Methods This prospective observational study consisted of 72 patients. The Distress Tolerance Scale (DTS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pain Catastrophizing Scale (PCS) were completed in the preoperative period. In the postoperative period, pain intensity, as measured with the Visual Analogue Scale (VAS), and morphine consumption (mg) were evaluated after 2, 6, 8, and 24 hours. Total morphine consumption was recorded. Results The results revealed a strong negative correlation between distress tolerance and postoperative total morphine consumption (r = -0.702, p< 0.001). There was a strong positive correlation between total morphine consumption and pain catastrophizing (r = 0.801, p< 0.001). A moderate positive correlation was observed between total morphine consumption and anxiety and between total morphine consumption and depression (r = 0.511, p< 0.001; r = 0.556, p< 0.001, respectively). Linear regression revealed that distress tolerance, anxiety, depression, and pain catastrophizing are predictors of postoperative morphine consumption (β = 0.597, p< 0.001; β = 0.207, p= 0.036; β = 0.140, p= 0.208; β = 0.624, p< 0.001, respectively). Conclusions Distress tolerance, anxiety, depression, and pain catastrophizing can be predictive of postoperative analgesic consumption. In the estimation of postoperative analgesic consumption, distress tolerance, as well as anxiety, depression, and pain catastrophizing, were found to be important predictors.

Associations between postoperative analgesic consumption and distress tolerance, anxiety, depression, and pain catastrophizing: a prospective observational study.

BACKGROUND: Patients' postoperative treatment might be affected by their psychological state. The study aimed to evaluate the effects of anxiety, coping ability (stress tolerance), depression, and pain catastrophizing on analgesic consumption in patients scheduled for sleeve gastrectomy. METHODS: This prospective observational study consisted of 72 patients. The Distress Tolerance Scale (DTS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Pain Catastrophizing Scale (PCS) were completed in the preoperative period. In the postoperative period, pain intensity, as measured with the Visual Analogue Scale (VAS), and morphine consumption (mg) were evaluated after 2, 6, 8, and 24 hours. Total morphine consumption was recorded. RESULTS: The results revealed a strong negative correlation between distress tolerance and postoperative total morphine consumption (r = -0.702, p < 0.001). There was a strong positive correlation between total morphine consumption and pain catastrophizing (r = 0.801, p < 0.001). A moderate positive correlation was observed between total morphine consumption and anxiety and between total morphine consumption and depression (r = 0.511, p < 0.001; r = 0.556, p < 0.001, respectively). Linear regression revealed that distress tolerance, anxiety, depression, and pain catastrophizing are predictors of postoperative morphine consumption (ß = 0.597, p < 0.001; ß = 0.207, p = 0.036; ß = 0.140, p = 0.208; ß = 0.624, p < 0.001, respectively). CONCLUSIONS: Distress tolerance, anxiety, depression, and pain catastrophizing can be predictive of postoperative analgesic consumption. In the estimation of postoperative analgesic consumption, distress tolerance, as well as anxiety, depression, and pain catastrophizing, were found to be important predictors.

Effect and Tolerability of Same-Day Repeat Colonoscopy.

Purpose/Aim of the study: The main purpose of the colonoscopy is screening for colorectal cancers and diagnosis of colorectal disease The cost-effectiveness of colonoscopy directly depend on the adequate bowel preparation. Inadequate colonoscopy is recommended to be re-scheduled within 1 year. Re-scheduling is an economic and patient burden. Thus instead of re-scheduling, another strategy may be attempted. The purpose of this study was to examine the usefulness and effect of the same day repeat colonoscopy after administration of an additional laxative dose. Materials and Methods: Patients with inadequate colonoscopy were enrolled in the study. The patients eligible for the enrollment were instructed to consume an additional laxative and scheduled in afternoon. The demographic data of the patient, the details of the index and repeat procedures were obtained by a questionnaire. Results: A total of 60 patients were enrolled in the study. The rate of adequate colonoscopy was 80%. Cecum intubation rate was 83.3%. There were no complications due to colonoscopy itself and additional laxatives. The polyp detection rate was 26.6%. The withdrawal time was 6.7 ± 1.34 min. Conclusion: The results of the present study showed that same day repeat colonoscopy with additional laxative dose can be a safe and effective method for repeat procedure of an inadequate colonoscopy. The patients tolerated and were satisfied with the same day protocol. Quality indicators of colonoscopy such as adenoma detection rate and cecum intubation rate were achieved. Same day bowel cleansing method may be considered as an alternative way rather than re-scheduling inadequate colonoscopy for a later time.

[Perioperative analgesic efficacy of bilateral superficial cervical plexus block in patients undergoing thyroidectomy: a randomized controlled trial]. / Eficácia analgésica perioperatória do bloqueio bilateral do plexo cervical superficial em pacientes submetidos à tireoidectomia: estudo clínico randomizado.

INTRODUCTION: Bilateral superficial cervical plexus block (BSCPB) is a common method used for analgesia in thyroid surgery. We investigated the analgesic efficacy of bilateral superficial cervical plexus block in the intraoperative and postoperative periods. MATERIALS AND METHODS: Patients (n = 46) undergoing thyroidectomy were randomly separated into the following 2 groups: the general anesthesia group (GA; n = 23) and the general anesthesia plus BSCPB group (GS; n = 23). The intraoperative analgesic requirement (remifentanil) visual analog scale (VAS) score at multiple time points during the postoperative period (after extubation, at 15 and 30 minutes and 1, 2, 6, 12, 24 and 48 hours post operation) were evaluated. Total tramadol and paracetamol consumption as well as the amount of ondansetron used was recorded. RESULTS: The intraoperative remifentanil requirement was significantly lower in the GS Group than in the GA Group (p = 0.009). The postoperative pain scores were significantly lower in the GS Group than in the GA Group at 15 (p < 0.01) and 30 (p < 0.01) minutes and 1 (p < 0.01), 2 (p < 0.01), 6 (p < 0.01), 12 (p < 0.01) and 24 (p = 0.03) hours. The postoperative tramadol requirement was significantly lower in the GS Group than in the GA Group (p = 0.01). The number of patients that used ondansetron was significantly lower in the GS Group than in the GA Group (p = 0.004). CONCLUSION: We concluded that BSCPB with 0.25% bupivacaine reduces the postoperative pain intensity and opioid dependency in thyroid surgery patients.

Perioperative analgesic efficacy of bilateral superficial cervical plexus block in patients undergoing thyroidectomy: a randomized controlled trial / Eficácia analgésica perioperatória do bloqueio bilateral do plexo cervical superficial em pacientes submetidos à tireoidectomia: estudo clínico randomizado

Abstract Introduction: Bilateral superficial cervical plexus block (BSCPB) is a common method used for analgesia in thyroid surgery. We investigated the analgesic efficacy of bilateral superficial cervical plexus block in the intraoperative and postoperative periods. Materials and methods: Patients (n = 46) undergoing thyroidectomy were randomly separated into the following 2 groups: the general anesthesia group (GA; n = 23) and the general anesthesia plus BSCPB group (GS; n = 23). The intraoperative analgesic requirement (remifentanil) and visual analog scale (VAS) score at multiple time points during the postoperative period (after extubation, at 15 , 30 minutes and 1, 2, 6, 12, 24, and 48 hours post operation) were evaluated. Total tramadol and paracetamol consumption as well as the amount of ondansetron used was recorded. Results: The intraoperative remifentanil requirement was significantly lower in the GS Group than in the GA Group (p= 0.009). The postoperative pain scores were significantly lower in the GS Group than in the GA Group at 15 (p< 0.01), 30 (p< 0.01) minutes, and 1 (p< 0.01), 2 (p< 0.01), 6 (p< 0.01), 12 (p< 0.01) and 24 (p= 0.03) hours. The postoperative tramadol requirement was significantly lower in the GS Group than in the GA Group (p= 0.01). The number of patients that used ondansetron was significantly lower in the GS Group than in the GA Group (p= 0.004). Conclusion: We concluded that BSCPB with 0.25% bupivacaine reduces the postoperative pain intensity and opioid dependency in thyroid surgery patients.

Resumo Introdução: O bloqueio bilateral do plexo cervical superficial (BPCS) é um método comumente usado para analgesia em tireoidectomia. Avaliamos a eficácia analgésica do bloqueio bilateral do BPCS nos períodos intraoperatório e pós-operatório. Materiais e métodos: Os pacientes (n = 46) submetidos à tireoidectomia foram randomicamente separados em dois grupos para receber anestesia geral (Grupo GA; n = 23) e anestesia geral mais bloqueio bilateral do BPCS (Grupo GS; n = 23). Avaliamos a necessidade de analgésico no intraoperatório (remifentanil) e os escores VAS (Visual Analog Scale) em vários momentos no pós-operatório (após a extubação, aos 15 e 30 minutos e em 1, 2, 6, 12, 24 e 48 horas de pós-operatório). O consumo total de tramadol e paracetamol e a quantidade usada de ondansetrona foram registrados. Resultados: A necessidade de remifentanil no intraoperatório foi significativamente menor no Grupo GS do que no Grupo GA (p = 0,009). Os escores de dor pós-operatória foram significativamente menores no Grupo GS do que no grupo GA aos 15 (p < 0,01) e 30 (p < 0,01) minutos e em 1 (p < 0,01), 2 (p < 0,01), 6 (p < 0,01), 12 (p < 0,01) e 24 (p = 0,03) horas de pós-operatório. A necessidade de tramadol no pós-operatório foi significativamente menor no Grupo GS do que no grupo GA (p = 0,01). O número de pacientes que recebeu ondansetrona foi significativamente menor no Grupo GS do que no Grupo GA (p = 0,004). Conclusão: O bloqueio bilateral do BPCS com bupivacaína a 0,25% reduz a intensidade da dor pós-operatória e a dependência de opioides em pacientes submetidos à tireoidectomia.

Management of foreign body ingestion and food impaction in adults: A cross-sectional study.

BACKGROUND: The management of food impaction and foreign body ingestion in the upper gastrointestinal tract requires careful evaluation and timely intervention. This study was a retrospective evaluation of the management of adult patients with such a history. METHODS: This study included adult patients admitted to a tertiary medical center with foreign body ingestion or food impaction between January 2012 and January 2018. The demographic and clinical data were recorded pro forma for statistical analysis. RESULTS: Of the 122 patients included in this study, 53.2% were male, and the mean age was 46.68+-18.64 years. In 84 of the patients (68.8%), the ingested object was food. Thirty patients were managed solely through laryngoscopy, while 61 patients (50%) underwent a flexible endoscopy. The patients with a foreign body ingestion were older than those with a food impaction (mean age: 51.3+-17.4 vs. 36.5+-17.4 years; p<0.001) and a plain radiograph showed the ingested material more often in those patients (36.8% vs 10.7%; p<0.001). Two patients underwent surgery due to perforations caused by the impacted material. No mortality was observed. CONCLUSION: The management of a foreign body ingestion or food impaction in an emergency setting requires a stepwise, algorithmic approach.

Primary hydatid cyst localized in soft tissue during pregnancy.

Hydatid cyst in pregnancy is a rare condition. Moreover, it is very rare that it is in the soft tissue other than the liver. In this case, there are no data in the literature on treatment options, but only experience in case presentations. We present a patient who had severe pain during pregnancy due to isolated soft tissue hydatid cyst disease in this case report.

Effect of sildenafil citrate on the liver structure and function in obstructive jaundice: An experimental study.

OBJECTIVE: We aimed to investigate the effect of 10 mg/kg sildenafil on the structure and function of the liver in a rat model of obstructive jaundice. MATERIAL AND METHODS: Sixty-two male Wistar albino rats were distributed into six different groups. Obstructive jaundice was performed by legating the common bile duct. 10 mg/kg sildenafil citrate in drinking water was delivered orally after the operation before sacrificing them. Rats were sacrificed either after 10 or 28 days according to the study design. The blood and tissue samples from the liver were obtained to perform a biochemical and histopathological analysis to study functional and structural changes in the liver. RESULTS: At the 10th day, there was no difference between the sildenafil-treated and control groups with regard to the aspartate aminotransferase and alanine aminotransferase levels (p=0.423, p=0.661). The alkaline phosphatase total bilirubin levels among the groups were statistically different (p<0.001). At the 28th day, liver function tests except alanine aminotransferase showed significant differences among the groups (p<0.001). Liver function tests did not changed significantly between the 10th and 28th day in sildenafil-treated rats (p>0.05). Significant differences were observed among the groups with regard to cholestasis, fibrosis, inflammation, and necrosis (p<0.001). However, edema increased in the sildenafil-treated group (p<0.001). On the 28th day, the severity of structural changes in the liver after obstructive jaundice, except edema, reduced significantly (p<0.001). The sildenafil-treated groups at different time points didn't show any statistical difference in histopathological changes (p>0.05). CONCLUSION: Oral administration of 10 mg/kg sildenafil citrate dramatically reverses the biochemical and histopathological liver changes induced by obstructive jaundice in rats.

Correction to: Effect of Sleeve Gastrectomy on Platelet Counts and Mean Platelet Volumes.

In the original article, in the Results section of the Abstract the text "…(10.41 ± 1.23 fL, p > 0.001)" should be changed to "…(10.41 ± 1.23 fL, p < 0.001)". The same error occurs on the next page of the article in the second paragraph of the Results section of the main text.

Treatment of phytobezoars: Tailoring management to diverse presentations.

OBJECTIVE: A minimally invasive approach is feasible and successful for the treatment of phytobezoars. We would like to draw attention to the overconsumption of Sorbus domestica and discuss the management options of patients presenting with different symptoms due to phytobezoars. MATERIAL AND METHODS: Data from patients diagnosed with phytobezoars in the Department of General Surgery from 2010 to 2016 were prospectively collected and evaluated. RESULTS: Twenty patients diagnosed with phytobezoars were included in the study. The etiology of phytobezoar was Sorbus domestica seeds in 12 patients, watermelon seeds in two patients, Japanese persimmon seeds in one patient, and unidentified in five patients. Fourteen patients underwent surgery, while the remaining patients were treated conservatively. Minimally invasive surgery was used in all but two cases, where the surgery was converted to laparotomy. Two patients developed postoperative morbidity. There was no mortality. CONCLUSION: The treatment modality should be selected for each patient according to the presenting symptoms and characteristics of phytobezoar. In cases where surgery is performed, a minimally invasive approach is feasible and successful for the treatment of ileus.

Effect of Sleeve Gastrectomy on Platelet Counts and Mean Platelet Volumes.

BACKGROUND: Obesity is a chronic metabolic disorder associated with cardiovascular disease, characterized by a chronic proinflammatory and prothrombotic state. The size and hemostatic potential of circulating platelets (PLTs) differ, with larger PLTs containing more granules and producing greater amounts of vasoactive and prothrombotic factors. This study aimed to investigate the effect of laparoscopic sleeve gastrectomy (LSG) on PLT count and mean platelet volume (MPV) in morbidly obese patients. METHODS: Two hundred five patients (females, n = 143; males, n = 62) who attended monitoring visits in the period prior to LSG and for 6 months after surgery were included in this study. Routine physical examination findings and laboratory parameters recorded preoperatively were compared with the same parameters in the postoperative 6th month. RESULTS: The mean age of the patients was 37.36 ± 10.93 years. The mean preoperative body mass index (BMI) of the patients was 47.65 kg/m2, whereas the mean postoperative BMI at 6 months was 31.49 kg/m2. Prior to LSG, the mean PLT count was 314.16 ± 76.40 × 109/L. At the postoperative 6th month, the mean PLT count was significantly reduced (263.17 ± 65.67 × 109/L, p < 0.001). In the preoperative period, the MPV was 10.12 ± 0.88 fL. In the postoperative period, it was significantly increased (10.41 ± 1.23 fL, p > 0.001). Both preoperatively and postoperatively, PLT counts were significantly higher in females than in males. After LSG, the MPV increased in both females and males. CONCLUSIONS: The results demonstrated that PLT counts decreased and MPV levels increased significantly after LSG and that the decrease in PLT counts was independent of changes in BMI.

Correction to: Which Bariatric Procedure Is the Most Popular in the World? A Bibliometric Comparison.

Some of the dates in the above published article were listed incorrectly; the correct details are shown below. The authors apologize for the mistaken text.

Which Bariatric Procedure Is the Most Popular in the World? A Bibliometric Comparison.

OBJECTIVE: This study aims to make a bibliometric analysis of the most commonly performed bariatric procedures between the years 2006 and 2016 and identify the most popular procedure in the field of bariatric surgery (BS). BACKGROUND: Despite the fact that BS popularity has been increasing considerably in recent years, the literature indicates insufficient information regarding the comparison of the methods used in BS. METHODS: The terms "Sleeve Gastrectomy," "Gastric Bypass," or "Gastric Band" were searched in Web of Science for the years between 1980 and 2016. All the publications found were subjected to bibliometric analysis. RESULTS: WoS database included 3501 publications about the sleeve gastrectomy keyword, 7278 publications about the gastric bypass keyword, and 2692 publications about the gastric band keyword. USA was found to be the most active country in all methods, and the authors who had most publications were Gagner M (64, 1.8%) for sleeve gastrectomy, Le Roux CW (83, 1.1%) for gastric bypass, and O'brien PE (50, 1.9%) for gastric band. "Obesity Surgery" was the journal that contributed most to the literature in all three obesity surgery procedures. CONCLUSION: Despite the fact that the top procedure was Roux-en-Y gastric bypass in terms of bibliometrics, the most popular procedure was found to be sleeve gastrectomy. According to the percentage of the increase in publications and citations, sleeve gastrectomy was found to be the method which showed the highest increase rates in recent years.

Effect of Laparoscopic Sleeve Gastrectomy on Thyroid Hormones in Euthyroid Obese Patients.

INTRODUCTION: In obese patients, the incidences of several thyroid disorders have increased in comparison to the general population. This study is aimed to investigate the effect of laparoscopic sleeve gastrectomy (LSG) on thyroid function tests in obese patients. METHODS: The patient files of 186 individuals who underwent laparoscopic sleeve gastrectomy surgery were examined retrospectively. Forty-nine females and 29 males comprising a total of 78 patients were included in the study. The routine physical examination findings and laboratory parameters recorded preoperatively were compared with their counterparts obtained in the postoperative sixth month. RESULTS: The mean preoperative body mass index (BMI) levels of the patients in the study was calculated as 46.91 kg/m2, whereas the mean BMI in the postoperative sixth month was 30.35 kg/m2 (p<0.001). Prior to the sleeve gastrectomy, the mean thyroid stimulating hormone (TSH) level of the patients was 2.53 ±2.06 µIU/mL; however, a significant reduction was observed in the mean TSH level during the postoperative sixth month, which was calculated as 1.77 ±1.12 µIU/mL (p=0.015). The mean free T4 level was 1.18±0.1 ng/dL in the preoperative period, but this increased to 1.22 ±0.24 ng/dL postoperatively, an insignificant change. The decrease in the TSH levels after the LSG was determined not to be correlated with the decrease in body weight. CONCLUSION: The results of our study demonstrate that the levels of TSH decreased significantly in patients who underwent LSG and that the decrease was independent of the changes in BMI.

Melatonin exhibits supportive effects on oxidants and anastomotic healing during intestinal ischemia/reperfusion injury.

BACKGROUND: The aim of this study was to investigate the effects of melatonin on intestinal anastomosis after intestinal ischemia/ reperfusion injury (IRI). METHODS: Thirty Wistar albino rats of both sexes were divided into 3 groups: sham, control, and treatment. IRI was performed by clamping the superior mesenteric artery (SMA) for 30 minutes, followed by reperfusion. The sham rats received only manipulation of the SMA. Melatonin (10 mg/kg) was administered to the treatment group, and the control group was given a vehicle injection. Both the treatment group and the control group further underwent ileal resection of a 1-cm segment and anastomosis. On the postoperative seventh day, the anastomotic burst pressure, hydroxyproline level, histological indices of wound healing, and oxidative parameters of catalase (CAT), superoxide dismutase (SOD), total glutathione (T-GSH), and glutathione peroxidase (GSH-Px) levels were measured. A one-way analysis of variance and chi-square test were used for the categorical data. RESULTS: Melatonin treatment led to a significantly higher burst pressure (p=0.027 and p<0.001, respectively). The 2 antioxidant enzymes, CAT and SOD, were at the highest level in the sham and melatonin groups and the lowest level in the control group (p=0.001 and p=0.002, respectively). Melatonin treatment resulted in a significantly higher level of both enzymes compared with the control group (p=0.026 and 0.003, respectively). The GSHpx and total GSH levels were slightly elevated in the treated rats, but the difference was not statistically significant (p=0.205 and 0.216, respectively). Fibroblast infiltration, capillary formation, and epithelialization were significantly better in the melatonin-treated animals. The granulocyte and mononuclear infiltration scores were similar between all groups. CONCLUSION: It was concluded that melatonin had marked effects on intestinal anastomotic healing during intestinal IRI.

The Evolution of Bariatric Surgery Publications and Global Productivity: A Bibliometric Analysis.

OBJECTIVE: This study aims to report on scientific production in bariatric surgery (BS). BACKGROUND: BS has gained popularity particularly in the last two decades and its indications have extended with the laparoscopic development and the metabolic activity of the surgical treatment. However, there is still little information on scientific production related to BS. METHODS: "Bariatric Surgery" or "Obesity Surgery" terms were searched through Web of Science focusing on the period 1980-2016. The analysis also included the correlations between economic productivity, humanity index, technological advancement levels, and performances of the countries in both fields. RESULTS: A total number of 17,568 publications was found. Of these, 9087 were conducted in the field of surgery. The most prolific journal was Obesity Surgery (4707, 26.8%). The most cited article according to average citations per year was published in the Obesity Surgery (average citations 90.40, total citation 452). Beside the number of publications, the USA was in the leading position in several other fields (active institutions, active journals, active authors, citation analysis, and international cooperation). Sweden was the most productive country in BS publications (4.505). Several factors related to the number of publications in BS demonstrated significant correlations in our study (p < 0.01). The highest correlation was found with GDP (r = 0.763, p < 0.001). CONCLUSIONS: The present study shows that the studies on BS has mainly been conducted in developed and developing countries.

Evaluation of the Alvarado scoring system in the management of acute appendicitis.

OBJECTIVE: In this study, we aimed to show the effectiveness of Alvarado score and its components to predict the correct diagnosis of acute appendicitis and to find an optimum cut-off value for Alvarado score. MATERIAL AND METHODS: The patients who underwent surgical operation between January 2011 and January 2012 with the suspicion of acute appendicitis were included in the study. Their demographic and clinical features and histopathological results were retrieved from the medical records. They were divided into three groups according to their Alvarado scores. With the use of "receiver operating characteristic" curve analysis, the optimum cut-off value needed to make a correct diagnosis of acute appendicitis was determined. RESULTS: In all, 156 patients were included into the study. The mean age was 31.41±13.27 years. Histopathologically, acute appendicitis was detected in 125 (80.1%) patients, and negative appendectomy was found in 31 patients (19.8%). Mean Alvarado score was 6.44±1.49. There was a significant correlation between negative appendectomy and low Alvarado score (p<0.001). The main component of Alvarado score that makes the difference was rebound. Fever higher than 37.3°C, rebound, loss of appetite, and existence of shifting pain were statistically differential components (p=0.042, p<0.001, p=0.045, p<0.001, respectively). The rate of correct diagnosis of acute appendicitis was maximum in group 3 (100%) and minimum in group 1 (21.7%). Optimum cut-off value for Alvarado score was 7. CONCLUSION: Patients with an Alvarado score of over 7 can be taken into surgical operation without the need of imaging methods.