Faisal G Bhopal, Bakhtair SH Ahmed, Manzoor Ahmed, Matloob Ahmed, Jahangir Sarwar Khan, Nadir Mehmood, Hamid Hassan, Muhammed Iqbal.
Role of TLC and C-Reactive Protein in the diagnosis of Acute Appendicitis.
J Surg Pak Jan ;8(2):14-7.

Acute appendicitis is one of the most common intrabdominal affections seen in surgical departments, which can be treated easily if accurate diagnosis is made in time otherwise delay in diagnosis and treatment can lead to douse peritonitis. A study was done to determine the role and predictive value of total leucocyte count (TLC) and C-reactive protein (CRP) in the diagnosis of acute appendicitis. All patients admitted with a clinical diagnosis of acute appendicitis and underwent appendectomy between September 2000 to March 2001 were included in this study. A11 patients presented within 24-36 hours of onset of pain. Out of 150 patients studied, 99 (66%) were males and 51 (34%) females. Age distribution was between 3years to 69years with a mean age of 20.3 years. In all patients who proved to have acute appendicitis (positive) TLC were found to be significantly high (p=0.025). The serum CRP levels were found to be either normal or at the high values of reference range (p=<0.001). In the group, with peroperative findings of gangrenous or perforated appendix both TLC count and CRP levels were found to be significantly high. These were compared with the group for negative appendecectomies Le. 19 patients. 17 out of these 19, (89.4%) had normal TLC and CRP levels. The sensitivity and specificity of serum CRP were 98% and 87.5% respectively with a predictive value (PV9 of positive test almost 98%.

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