Diagnostic value of total leukocyte count and neutrophil percentage in suspected cases of acute appendicitis

ABSTRACT

To define the role of serum markers of inflammation total leukocyte count, neutrophil percentage in diagnosis of acute appendicitis. Study Cross sectional analytic study. Surgical emergency and surgical unit-lV Nishtar Hospital Multan during July 2005 to March 2006. Study was carried out on 50 patients of either sex, above the age of 13 years presented with pain right side of the abdomen. These patients were subjected to complete blood examination including TLC and DLC. Of the 50 patients, 39 patients [78%] had TLC raised above 10.000 per mm[3] out of which 36 [72%] had inflamed, gangrenous or perforated appendicitis and 3 [6%] had normal appendicitis confirmed on histopathology. 11 patients had TLC below 10.000 per mm[3]. They all had inflamed appendicitis confirmed on histopathology. The sensitivity and specificity of TLC in the diagnosis of acute appendicitis were 76.6% and 33.3% respectively. The positive and negative predictive value were 92.3% and 9% respectively. The leukocytosis was attributed to the neutrophils leukocytosis associated with lymphopaenia. In this study there were 3 [6%] patients who had TLC below 10.000 mm[3] but they had neutophils to lymphocyte ratio 3.51 or above. They had inflamed appendices on histopathology. Laboratory test of white cells count and neutrophil percentage are more effective in supporting clinical diagnosis of acute appendicitis