Difficulties in indicating appendectomy; diagnosis of appendicitis in patients with normal white blood cell count

Authors : Veli VURAL

Pages : 35-38

Doi:10.5472/marumj.681990

View : 12 | Download : 3

Publication Date : 2020-01-31

Article Type : Research Paper

Abstract :Objectives: Even after 130 years have passed since the first appendectomy, diagnosing acute appendicitis can still be challenging. The objective of this study was to investigate clinical, imaging and laboratory findings of patients diagnosed with acute appendicitis in order to determine whether white blood cell count is helpful in the diagnosis. Materials and Methods: Parameters of Alvarado score, patients’ complaints, physical examination and laboratory findings were recorded. Appendiceal diameters of patients detected with ultrasound insert ignore into journalissuearticles values(US); were also recorded. Results: Of the 98 patients, 89 patients insert ignore into journalissuearticles values(91%); had an appendiceal diameter wider than 8 mm and 9 patients insert ignore into journalissuearticles values(9%); had an appendiceal diameter of 8 mm and smaller in the preoperative US. Pathology was normal in 8 out of 9 patients insert ignore into journalissuearticles values(89%); with a diameter of 8 mm and below; and 9 out of 89 patients insert ignore into journalissuearticles values(9%); with a diameter above 8 mm insert ignore into journalissuearticles values(p<0.05);. Sensitivity and specificity of the 8-mm cut-off was 99% and 47% respectively. Positive and negative predictive values were 90% and 89% respectively. Conclusion: Distribution of pathology results with respect to appendiceal-diameters revealed that there was an obvious threshold between normal and pathology-proven appendicitis. This outcome highlights the importance of imaging in the diagnosis.
Keywords : Appendicitis, Diagnostic ultrasound, White blood cell count