Context: Acute appendicitis is one the very common acute abdomen presenting to the emergency department. Many scoring systems and radiological modalities have been developed over the years for the diagnosis of acute appendicitis. Aims: Our objective is to study acute appendicitis, the various clinical patterns that help to make a clinical diagnosis and effectiveness of radiological investigation in diagnosing acute appendicitis and its influence on clinical decision making. Method: The study group included all the patients presenting to KIMS Hubli with suspected acute appendicitis and operated for the same during December 2016 to May 2018. Results: The current study included 172 cases. Out of which 61.8% were male and 38.2% were female. Majority of the study population belonged to the age group f 10-30 years. The most common symptom was pain abdomen followed by nausea and vomiting, fever and anorexia. Most common sign elicited was right iliac fossa tenderness and followed by rebound tenderness. On blood investigations 66.5% of the patients had leukocytosis of >10,000. 64.1% of the patients had Alvarado score of 7 and more. As per USG, 94.1% of them had signs of acute appendicitis. The most common position in our study is retrocecal. Appendicitis was reported in all the cases on histopathological examination. Conclusion: Clinically diagnosing a case of appendicitis based on symptoms and signs combined with affordable radiological investigations can reduce unnecessary delay in the operative management of acute appendicitis. It is evident in our study that clinical and radiological investigations have no specificity in clinical diagnosis of acute appendicitis.

Keywords: RIF- right iliac fossa, USGultrasonography