APPENDICITIS IN PEDIATRICS: DIAGNOSTIC VALUE OF LEOKOCYTE COUNT, CRP, NEUTROPHIL TO LYMPHOCYTE RATIO

Abstract

Introduction. Appendicitis is the most common cause of acute surgical abdomen. However, many atypical manifestations of this disease make much difficulties in differential diagnosis. Diagnostic methods such as sonography or isotope scan are expensive or completely depend on sonographist's experience. So because there is no preoperative definite diagnostic test for appendicitis patients, it seems necessary to evaluate different variables to achieve this goal. Laboratory tests are inexpensive and available.
Methods. A Series of 116 consecutive under 14 years old patients presenting with right lower quadrant pain were studied. All of the patients underwent operation and diagnosis was confirmed by histology. WBC count> 10000/mm3, neutr/Lymph>3/5 and positive CRP were indices of study.
Findings. The sensitivity of WBC count above 10000/mm3, neutrophill to lymphocyte count ratio (>3/5) and positive CRP were 96, 76 and 70 percent, respectively. The specificity of them were 46, 65 and 68 percent. The sensitivity of combination of variables 53 percent and the specificity was 82 percent.
Conclusion. These findings suggest that each of studied variable are usefull for diagnosis of acute appendicitis but the combination is usefull for rule- out the disease.