Publication:

Clinical correlates of positive and negative cases of appendicitis

Background The diagnosis of acute appendicitis is essentially clinical; however, a decision to operate based on clinical suspicion alone can lead to the removal of a normal appendix in 15-30% of cases. A number of clinical and laboratory based scoring system have been devised to assist diagnosis.

Methods A detailed history as to the method of presentation, thorough clinical examination and all patients were investigation with routine blood tests, WBC count, DC, USG abdomen and Pelvis, X-ray, blood grouping and Rh typing, and histopathological study of the appendix were performed and reported by senior pathologist of the department.

Results In the study population of 100 patients, 84 were histopathologically proved appendicitis. Among them 64 (76.2%) had raised leucocyte count and 20 (23.8%) had normal leucocyte count. Out of 16 histopathologically negative cases, 5 (31.3%) had raised leucocyte count and 11 (68.7%) had normal leucocyte count.

Conclusions Negative appendectomy rate can be decreased, if appendectomy is avoided in cases where WBC count, neutrophil count and grade compression sonography (USG) abdomen normal.