Diagnostic Value of C Reactive Protein Measurement in Patients with Acute Appendicitis
Iraqi Postgraduate Medical Journal,
2007, Volume 6, Issue 4, Pages 347-351
To evaluate the role of crude measurement of C-reactive protein in the diagnosis of acute appendicitis.
Appendicectomy for suspected acute appendicitis is a common procedure. The rate of normal appendices unnecessarily removed remain high(15%-30%) ; despite several techniques and investigations used to improve the diagnostic accuracy . Many studies investigated the role of raised C-reactive protein (CRP ) in improving the diagnosis of acute appendicitis, but with conflicting results.
PATIENTS AND METHODS :
This is a randomized prospective study from February to July 2006 . A total of 100patients were included in this study that presented to our hospital with acute right iliac fossa pain and later on operated and had appendicectomy .Blood for the measurement of serum C-reactive protein(CRP) was collected preoperatively from all the patients. The patients divided in to two groups ,those who are positive appendicitis proved by operative finding and histopathological examination and those with negative appendicitis proved by histopathological examination.
A total of 100 patients were included in this study, and out of these 16 (16%) had normal appendix giving an over all negative appendicectomy rate of 16% out of these 5 were males and 11 were females ,the age range was (6-47 years) with a median age of ( 25.92) years . Among the 84 who had appendicitis, 64 patients had obstructive type of appendicitis which were noticed during the operation ,and CRP was positive in all patients, but only 9 of them were with CRP negative . 4 perforated appendicitis were found in which all of them were CRP positive, and 16 patients with catarrhal appendicitis were diagnosed by histopathological examination and only 3 patients out of those had negative CRP while the remainder were positive.
The positivity of CRP was related to the severity of inflammation; but it is more reliable to depend on negative results to postpone the operation and observe the patient .Thus unnecessary removal of normal appendices may be reduced.
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