Diagnostic Value of Inflammatory Markers in Acute Appendicitis

Abstract

Background: Appendicitis in children is a common surgical emergency and its diagnosis remains challenging. Diagnosisusing blood inflammatory markers is still debatable. The purpose of this study was to determine the effectiveness of bloodinflammatory markers obtained during routine blood tests in diagnosing acute appendicitis in childrenin addition torespondent's demographic data as well. Methods: This was a descriptive cross-sectional study conducted between January 2018 to June 2019 at the Department ofSurgery of Sylhet MAG Osmani Medical College Hospital to determine the value of blood inflammatory markers in thediagnosis of acute appendicitis. The study enrolled 246 patients who underwent surgery for acute appendicitis based onclinical/ultrasonographic diagnosis. Prior to surgery, white blood cell (WBC) count and C-reactive protein (CRP) levels of thepatients were measured, and their sensitivity was analyzed based on histopathological diagnosis. Results: The mean age of the 246 study participants was 28.31±10.12 years. Histological confirmation of acute appendicitiswas obtained in 212 cases. The male-female ratio was 2.21:1 in 212 cases of confirmed appendicitis. WBC counts had asensitivity of 84% and CRP 76% while those were elevated alone. But the sensitivity and specificity increased to 91% and 75%,respectively when both the WBC counts and CRP levels were raised. Conclusion: When only the WBC count or CRP is performed, no additional information can be obtained to help the diagnosisof acute appendicitis. However, the diagnostic sensitivity increases when both WBC count and CRP level are raised. Keywords: Acute appendicitis, Laboratory diagnosis, Children, White blood cell, C-reactive protein