Value of total leucocytic count and pelvic-abdominal ultrasound in distinguishing complicated from noncomplicated acute appendicitis

Abstract

Background Complicated appendicitis is associated with elevated rates of morbidity and mortality compared with noncomplicated appendicitis. In this study, we aimed to investigate the role of combining total leucocytic count (TLC) and abdominal ultrasound (US) in distinguishing simple from complicated appendicitis. Patients and methods This is a prospective study that included patients with acute appendicitis who underwent appendectomy. The patients’ data regarding demographic characteristics, clinical, laboratory, and US findings, as well as intraoperative findings and postoperative complications, were recorded and analyzed. Results This study included 80 patients. Overall, 48 (60%) patients had noncomplicated appendicitis, and 32 (40%) had complicated appendicitis. Patients with complicated appendicitis had significantly higher ages and TLC. Concerning the US findings, significantly higher cases of visualized blind-ended loop (P = 0.042), right iliac fossa fluid (P = 0.006), and pelvic collection (P < 0.001) were shown in the complicated group. Multiple regression analysis revealed that TLC and the presence of pelvic collection by the US were the only variables significantly predicting complicated appendicitis. Adopting either a TLC cut-off value of 12.95×109/l and/or the presence of pelvic collection for the diagnosis yielded a sensitivity of 90.6%, a specificity of 77.1%, and an accuracy of 82.5%. Conclusion The presence of a TLC cut-off value of 12.95×109/l and/or a pelvic collection in abdominal ultrasound seems to be reproducible for the preoperative prediction of complicated acute appendicitis.