The effect of appendix diameter on perforation in acute appendicitis cases

Abstract

Objective: The aim of the study is to examine the association between appendix diameter and perforation and to show the significance of appendix diameter in acute appendicitis cases. Method: The data of 286 cases who were older than 18 years of age and who were operated in a tertiary hospital between 2017 and 2018 with a diagnosis of acute appendicitis were examined retrospectively. The patients’ ages, genders, pathology results, appendix diameter at abdominal tomography, white blood cell (WBC) and C-reactive protein (CRP) values were analyzed. The patients were grouped in three as perforated, non-perforated and negative appendectomy group. Results: Of the 286 patients operated with a diagnosis of AA, 166 (58%) were male, while 122 (42%) were female and average age of the patients was 37±16.79 years. Non-perforated group consisted of 194 patients, while perforated group consisted of 56 patients and negative appendectomy group consisted of 36 patients. Average appendix diameter of the patients was 8.84±3.29 mm, while average WBC value was 13071±3726/mm 3 and average CRP value was 3.44±5.15mg/L. When the patients’ appendix diameters and CRP values were compared, statistically significant difference was found between the groups (p<0.001). Average value of white blood cell was the lowest in negative appendectomy group, while it was the highest in perforated group. There was a statistically significant difference between negative appendectomy group and the other two groups in terms of white blood cell (p<0.001). There was a positive correlation between the groups in terms of appendix diameter, white blood cell and CRP (p<0.001). Conclusions: Appendix diameter is important in the diagnosis of acute appendicitis and detection of perforated appendicitis. Appendix diameter is correlated with white blood cell and CRP.