Role of Immature Granulocyte Count and Percentage in The Differential Diagnosis of Appendicitis

Abstract

Objective: Acute appendicitis is one of the most important and widely performed emergent surgery in pediatric surgery practice. Diagnosis of appendicitis in children is more challenging compared to adults. The immature granulocyte percentage (IG%) is recently investigated laboratory parameter for detection of inflammation severity in adult population . The aim of the study was determination of IG count and percentage role in early detection of pediatric acute appendicitis. Materials and Methods: The data of patients who applied to Emergency Room with the complaint of abdominal pain and who were operated with a pre-operative diagnosis of acute appendicitis between January 2021 and December 2022 retrospectively reviewed from hospital records. Patients under 18 years, operated due pre-operative diagnosis of acute appendicitis and who have hemogram included in the study. Results: One hundred eight patients included in the study. Fourty-eight patients were in the acute appendicitis group, 9 patients were in the perforated appendicitis group, and 53 patients were in the control group. The mean IG % of was 0.31±0.37 and 0.96±5.1 in appendicitis and control group patients, respectively. No significant difference was found between appendicitis patients and control group in terms of IG number and percentage. No statistically significant difference was found between acute and perforated appendicitis in terms of IG number and IG%. Conclusion: IG number and IG% did not provide any additional benefit and is not a conclusive biomarker for clinician in determination of acute appendicitis. A combination of anamnesis, physical examination and laboratory test remains gold standard for diagnosis of acute appendicitis.