THE VALUE OF INFLAMMATORY MARKERS FOR DIAGNOSIS AND INDICATION OF SEVERITY OF ACUTE APPENDICITIS
Abstract
Introduction: The purpose of this work was to recognise the value of clinical manifestations and laboratory tests to establish the diagnosis of acute appendicitis and the severity of histopathology findings.
Materials and methods: This study evaluated 272 patients surgically treated for acute appendicitis, mean age 40 years old, between 2012 and 2013. Clinical and laboratory parameters were collected and then correlated with results of histopathology.
Results: Histopathology confirmed the diagnosis of acute appendicitis in 238 (87.5%) cases: phlegmonous in 32, suppurative in 164, gangrenous/perforated in 42. No statistical difference was found in clinical manifestations between the group with confirmed acute appendicitis and the group with normal appendix. The leucocyte count was significantly superior in the group with confirmed acute appendicitis, however was not statistically different between the histological types. Leucocyte count of 10850x106/L showed discriminative power between normal appendix and inflamed appendix with a sensitivity, specificity and positive predictive value of 84.6%, 76,1% and 98.9% respectively. The C-Reactive protein was related to the severity of the inflammation, and a value of 5,27mg/dl was correlated with gangrenous/perforated appendicitis.
Discussion/Conclusions: Leucocyte count superior than 10850x106/L can support the diagnosis of acute appendicitis when clinical suspicion exists. C-Reactive protein is related to the severity of inflammation.
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References
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