Jehangir S Khan, Hassan H, Khan J A.
Investigations for Acute Appendicitis: Can we rely on them?.
Pak J Surg Jan ;18(2):27-30.

The commonest cause of emergency abdominal surgery is acute appendicitis. However diagnosis of acute appendicitis poses great difficulty. A prospective study was conducted at Surgical Unit-II, Rawalpindi General Hospital, over a period of three years. Purpose of study was to determine value of various investigations used in the diagnosis of acute appendicitis and their correlation with histopathological diagnosis. Total leukocyte count (TLC), urine routine examination, abdominal ultrasound and C-reactive protein level (CRP) were investigations studied. A total of 500 patients were included in the study. There were 348 (69%) male and 142 (31%) female patients with a ratio of 2.3:1. Mean age was 20.6 years. Commonest age group was 11 years to 30 years (73%). On basis of histopathology, incidence of negative appendicectomy was 15% (75 cases). When we correlated the results of histopathology with these investigations, the sensitivity of TLC was 73% and specificity 80%. The sensitivity of urine RIE was only 9.4% and specificity 73%. Likewise, the sensitivity of abdominal ultrasound was 86.2% and specificity 91.8%. CRP sensitivity was highest, 98.6% and specificity 88%. Hence it can be concluded that we cannot rely on any single investigation, but a combination of such investigations along with thorough physical examination is essential for accurate diagnosis of acute appendicitis.

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