Study of clinical, laboratory and imaging parameters in diagnosing acute appendicitis
Journal Title: Medpulse International Journal of Surgery - Year 2018, Vol 5, Issue 3
Abstract
Objective: Aim of the study was to evaluate accuracy of Clinical, Laboratory and Imaging parameters in Diagnosing Acute Appendicitis Methods: A prospective study of 160 patients who were admitted to the Surgery Department of Khaza Banda Nawaz Institute Of Medical Sciences, Kalaburagi, during February 2016 to January2018; and underwent appendectomy at first presentation. Age of presentation was between 5 years to 35 years. Data collected for each patient included demographics (age and sex), clinical information (duration of symptoms, physical signs at examination on admission to the Surgery Department), laboratory tests (WBC and neutrophil counts), results of imaging tests, and pathology results.We compared the pathology reports of 160patients with the preoperative assessment of acute appendicitis. Results: Over 2-year period, 160 children were admitted and underwent appendectomy at first presentation in Department of Surgery for suspected acute appendicitis. The study population included 160 patients 90 males (56.25 %) and 70 females (43.75%) who underwent surgery for suspected acute appendicitis. The age at presentation was between 5 years to 35 years. The study population was divided into 2 groups according to the pathology results. Group I consisted of 148 patients (92.5 %) diagnosed with acute appendicitis. Group II included 12 (7.5 %) patients who had a normal appendix based on pathological examination. No differences were found between acute and normal appendices with regard to clinical complaints. However, laboratory and imaging results showed differences between groups. Fever on admission to hospital was higher in patients with acute appendicitis (37.5 °C ± 0.8 vs. 36.8 °C ± 0.7) as were WBC values (14.5 ± 4.9×10 3/ mL vs. 10.2 ± 3.6 × 10 3 / mL ) and neutrophils (75% ± 10.1 vs. 60.0 % ± 12.9). Ultrasonogram (USG) was performed in all patients. The appendicular diameter was significantly smaller in patients with a normal appendix compared to those with acute appendicitis (0.7 ± 0.08cm vs. 0.9 ±0.2cm, respectively). Conclusion: The results of laboratory tests (WBC, Neutrophils) and Imaging (USG) contributed far more than clinical parameters to the accurate diagnosis of acute appendicitis. When these 3 parameters were positive, the probability of normal appendix was less than 1%. The contribution of USG was particularly high as its results matched the final diagnosis.
Authors and Affiliations
Nandkishor Shinde, Mohammed Abdul Baseer
Keywords
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