A clinical study on acute appendicitis with special reffrence to TLC, DLC, C-reactive protein and plain x-ray abdomen

Abstract

Objective: To diagnose the case of acute appendicitis accurately on basis of a combined criteria including TLC,DLC,CRP and plain X ray abdomen so that timely intervention can be performed and avoiding negative laparatomies in term of better management of patient in patient with acute right lower quadrant of abdominal pain. Methods During the study period of 18 months, 60 patients between the ages of 11 and 65 years operated upon for suspected acute appendicitis were included in this prospective study. Both open as well as laparoscopic appendectomies were included in the study. On admission, note was made of the symptoms and signs relevant to the study. Venous blood was routinely taken on admission and was sent to the emergency laboratory for testing. Results The present study revealed that males were affected more than females and the commonest age group affected was 11 – 20 year age group. Pain, anorexia, vomiting and fever seems to be the reliable symptoms and one should deeply inquire about these symptoms. RLQ tenderness and rebound tenderness along with tachycardia were the commonest signs and presence of all three should highly suggest the diagnosis of acute appendicitis. An increase in C-reactive protein level is highly sensitive in diagnosing inflammatory condition like acute appendicitis, but again it has low specificity and results should be interpreted along with valid clinical picture. Plain x-ray abdomen can serve as an important adjunct in the diagnosis of acute appendicitis, with RLQ ‘sentinel loop’ being the commonest finding. Conclusion If all the investigations such as TLC, DLC, CRP and PLAIN X-RAY ABDOMEN are combined, it can highly increase the sensitivity and positive predictive value in diagnosing acute appendicitis.