Serum C - Reactive Protein as an Aid to the Diagnosis of Acute Appendicitis and Its Importance in Reducing the Rate of Negative Appendectomy

Abstract

Introduction: Acute appendicitis represents one of the most common abdominal surgical emergencies and appendectomy being the only treatment, is one of the most commonly performed operations, plagued with a high rate of negative exploration.

Objective: The main objective of this study was to assess the accuracy and efficacy of CRP over TLC in the diagnosis of acute appendicitis.

Methods: The study includes a total of 200 patients who had been diagnosed with acute appendicitis based on WBC count and clinical evaluation and were planned for appendectomy. Serum CRP was estimated in these patients along with WBC count before the operation but was not taken into account in the decision-making process of appendectomy. All the removed appendixes were sent for histological examination.

Results: Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of serum CRP was 94.1%, 73.3%, 95.23%, 68.75%, 91% whereas that of WBC was 88.23%, 60%, 92.59%, 47.36% and 84%.

Conclusions: Serum CRP should be considered along with other laboratory parameters and clinical evaluation in the diagnosis of acute appendicitis to reduce the rate of negative appendectomy.