Title: Role of Serum C-Reactive Protein Levels in Diagnosis of Acute Appendicitis
Authors: Dr Bhagwan.C. Balagopal, Dr Shilpy Gangawala, Dr Lohith Shetty Raju, Dr Rewanth R Katamreddy, Dr Hemanth Vupputur
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.06
Abstract
Background: Appendectomy is one of the most common surgical emergencies. Despite of manyadvances in biochemical and radiological investigations, rate of negative appendectomy [histopathology negative] is considerably high.
Aims: Is to emphasize the impact of a normal (rather than raised) serum C - reactive protein (CRP) in reducing the rate of negative explorations. The chief objective of the present study is to correlate pre-operative serum levels of C-reactive protein and elevated WBC counts with the histopathology of the removed appendix to reduce the rate of negative appendectomies.
Methods and Material: The present study included 100 patients over a period of one year from January 2013 to January 2014. Pre-Operative investigations were done which included WBC count and CRP levels. Postoperative histopathological report was correlated with WBC count and CRP levels. We tried to evaluate the efficacy of CRP and WBC count in the diagnosis of appendicitis and to see whether negative appendectomies could be avoided.
Results: In 100 cases of appendectomy, 85 patients (85%) had histologically proved appendicitis.15% underwent negative appendectomy. TLC >10,000 cells/mm3 was seen in 42(42%) patients, out of which 40 had HPE proved appendicitis (P=0.015). CRP was positive in 76.5% of HPE proved appendicitis patients. Of the 15 patients who had HPE negative appendix, 14 (93%) had negative CRP (P<0.01).
Conclusions: CRP levels combined with Total Leukocyte Count can play a significant role in diagnosis of acute appendicitis. Whenever CRP and TLC are normal diagnosis other than appendicitis should be considered.
Keywords: Acute Appendicitis, CRP, TLC, Histopathology, Negative Appendectomy.
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