Role of total leukocyte count and C-reactive protein in diagnosis of acute appendicitis

Abstract

Background: Acute appendicitis is still one of the most common surgical emergencies. This study was conducted to check the sensitivity and specificity of Total leukocyte count (TLC) and C Reactive Protein (CRP) of acute appendicitis. Aim and objectives were to check the sensitivity and specificity of total leukocyte count in diagnosis of acute appendicitis and to check the sensitivity and specificity of CRP in diagnosis of acute appendicitis. To determine TLC and CRP efficacy in diagnosis of acute appendicitis.Methods: TLC and CRP were calculated in all patients who were planned to undergo appendectomy. Appendectomies were performed independent of results of TLC and CRP levels. For statistical purpose the patients were assigned into 2 groups- Group-A Patients with inflamed/perforated/gangrenous appendix, Group-B patients with Normal appendix. The normal TLC and CRP values, raised TLC, raised CRP, and raised both TLC and CRP values calculated in each of these groups. Sensitivity and Specificity were calculated. The cut off value for TLC was 11x106/L. This value was selected arbitrarily as it corresponds to the elevated TLC. The CRP levels were calculated and cut off value was taken as 1.7mg/dl.Results: Out of 75 cases, 55 were male and 20 were female. Age ranged from 13 to 58 years. CRP was raised in 82.14% of inflamed appendix cases TLC was raised in 76.79% of inflamed appendix cases and both was raised in 92.5% of inflamed appendix cases.Conclusions: TLC and CRP are useful in diagnosis of acute appendicitis. Negative appendicectomy rate can be decreased.

Total Leukocyte Count Depicting the Degree of Inflammation in Acute Appendicitis

“…AA is the most common cause of the acute abdomen requiring surgery with a lifetime risk of 7%, which is maximal in childhood and declines steadily with age as the lymphoid tissue and vascularity atrophy [1].…”

“…AA is the most common cause of the acute abdomen requiring surgery with a lifetime risk of 7%, which is maximal in childhood and declines steadily with age as the lymphoid tissue and vascularity atrophy [ 1 ]. Although only a few patients progress to the potentially lethal complications, early surgery for all patients with suspected appendicitis has become the definitive method of preventing severe peritoneal sepsis [ 2 ].…”

“…CT scan is the current gold standard yet, the diagnosis of acute appendicitis is usually made on various clinical findings [ 2 ]. However, a missed case of acute appendicitis is a catastrophe as it later presents with life-threatening complications and results in medicolegal issues [ 1 , 2 ]. Raised total leukocyte count is a frequent finding in patients with acute appendicitis.…”

“…Acute appendicitis (AA) is the most common abdominal surgical emergency [ 1 ]. Patients present often with typical symptoms and physical findings.…”

A comparative study on the diagnostic validity of three scoring systems in the diagnosis of acute appendicitis in emergency centres

“…The diagnostic scoring systems along with laboratory and biochemical tests have been more reliable to diagnose acute appendicitis in some studies. C-reactive protein (CRP) is an inflammatory marker which has been used to increase the accuracy of diagnostic scoring systems [ [3] , [4] , [5] ]. However, its diagnostic accuracy has been variable in different studies [ 7 , 8 ].…”