Significance Of C-Reactive Protein Levels in reducing negative explorations for acute appendicitis

ABSTRACT

To study the significance of C-Reactive Protein in improving the diagnosis of acute appendicitis and to assess its role in preventing negative appendicectomies.Prospective, double blind study.Sarfaraz Rafiquee Shaheed Hospital and Faiz-e-Aam Hospital, Karachi.100 consequtive patients with acute appendicitis who underwent surgery. Blood sample from 100 patients were collected pre-operatively for Total Leucocyte Cont [TLC] and C-Reactive Protein [CRP]. All specimen removed were sent for histopathology. The TLC, CRP and histopathology findings were correlated, and patients grouped into positive [acute appendicitis] and negative [normal appendix] cases. In patients with histopathologically proven acute appendicitis, both the TLC and CRP were significantly raised, p-0.025 and p<0.0001 respectively. However, in 16 out of 19 negative explorations [normal appendix on histopathology], serum CRP level was found to be normal. The specificity and sensitivity of serum CRP was 84.21% and 93.8% respectively.A normal pre-operative serum CRP measurement in patients with suspected acute appendicitis is most likely associated with a normal appendix. Deferring surgery in this group of patients and/or further investigation into other possible causes might reduce the rate of unnecessary appendicectomies