ABSTRACT
Background: Acute appendicitis is the most common abdominal surgical emergency, but its diagnosis remains an enigmatic challenge, plagued by a high rate of negative explorations. There is no single reliable test with satisfactory sensitivity and specificity. Ultrasonography is not often available at a rural surgical setup. This study is intended to evaluate the importance Aim: of serum C-reactive protein (CRP) level estimation in diagnosis of acute appendicitis, by comparing with histopathology report. In a Methods: prospective study,100 patients clinically diagnosed as acute appendicitis were selected by purposive sampling method and evaluated as per criteria for serum CRP levels, leucocyte count preoperatively and were followed up postoperatively with histopathology reports. The data was analysed for finding the significance of serum CRP in the diagnosis of acute appendicitis. CRP was positive in 75 of the 77 patients who Results: had histologically proven acute appendicitis and in 3 with normal appendix. The sensitivity, specificity and diagnostic accuracy were 97.4%, 86.96% and 95% respectively. Leucocytosis and neutrophilia when used alone were not specific for acute appendicitis, but when combined with CRP value, diagnostic accuracy was high. Ultrasonography was useful in establishing alternative diagnoses, but had low sensitivity for acute appendicitis. CRP contains important diagnostic information and hence should always Interpretation & Conclusion: be included in the diagnostic workup of acute appendicitis. Since acute appendicitis is very unlikely in those patients with normal WBC count and CRP value, conservative treatment is advised.This study does not undercut the skill of an experienced surgeon in diagnosing acute appendicitis, but CRP estimation compliments clinical diagnosis.