Acute Appendicitis

Wolfe, Jeannette; Henneman, Philip L.

doi:10.1016/b978-0-323-05472-0.00091-8

Cited by 3 publications

(5 citation statements)

References 72 publications

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“…Several reports suggest that an elevated leukocyte count is usually the earliest laboratory test to indicate appendiceal inflammation, and most of the patients with acute appendicitis present with leukocytosis [25] despite several studies that acknowledge the limitations of this test [26,27]. Sack et al [28].…”

Section: Discussionmentioning

confidence: 99%

“…In this study, WBCs and neutrophil counts were significantly higher in patients with inflamed and complicated than normal appendix and in complicated than inflamed appendix. Several reports suggest that an elevated leukocyte count is usually the earliest laboratory test to indicate appendiceal inflammation, and most of the patients with acute appendicitis present with leukocytosis [ 25 ] despite several studies that acknowledge the limitations of this test [ 26 , 27 ]. Sack et al [ 28 ].found that WBCs count was clearly elevated in children with phlegmonous and perforated appendicitis.…”

Section: Discussionmentioning

confidence: 99%

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Clinical value of total white blood cells and neutrophil counts in patients with suspected appendicitis: retrospective study

Al-Gaithy

2012

World J Emerg Surg

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IntroductionAcute appendicitis (AA) is common surgical problem associated with acute-phase reaction. Blood tests role in decision-making process is unclear. This retrospective study aimed to determine diagnostic value of preoperative evaluation of white blood cells (WBCs) and neutrophils and its value in predicting AA severity.MethodsMedical records of 456 patients who underwent appendectomy during 4-years period were retrospectively reviewed. Patients were subdivided according to histological finding into: normal appendix (n = 29), uncomplicated inflamed appendix (n = 350), complicated appendicitis (n = 77). Diagnostic performances of WBCs and neutrophils were analyzed using receiver operating characteristic (ROC) curves.ResultsWBCs and neutrophils counts were higher in patients with inflamed and complicated appendix than normal appendix and in complicated than inflamed appendix. In patients, WBCs count 9.400 × 103/mL had sensitivity of 76.81%, specificity of 65.52%, positive predictive value (PPV) of 97.0%, negative predictive value (NPV) of 16.1%, positive likelihood ratio [LR(+)] of 2.23, negative LR(−) of 0.35. Neutrophil count 7.540 × 103/mL had sensitivity of 70.96%, specificity of 65.52%, PPV of 96.8%, NPV of 13.3%, LR(+) of 2.06, LR(−) of 0.44. Areas under ROC curve were 0.701, 0.680 for elevated WBCs and neutrophils count.ConclusionsClinicians should not rely on either elevated WBCs or neutrophils count as appendicitis indicator as clinical data are superior in decision-making appendectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical value of total white blood cells and neutrophil counts in patients with suspected appendicitis: retrospective study

Al-Gaithy

2012

World J Emerg Surg

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“…Infectious colitis and gastroenteritis generally present with more diarrhea and vomiting than usually occurs in appendicitis, but there can be considerable overlap in patient symptoms. [ 6 ] Ultrasound findings consist of thickened bowel wall, which may show hyperemia. The normal bowel wall thickness is <3 mm.…”

Section: Nfectious C Olitismentioning

confidence: 99%

“…[ 1 2 ] Although appendicitis is the most common surgical emergency,[ 3 ] there are many other causes of right iliac fossa pain that must be considered when evaluating these patients [ Table 1 ]. [ 1 2 3 ] Ultrasound is frequently recommended as the primary imaging modality for the investigation of acute abdominal pain, especially in young patients,[ 4 5 6 ] and can often demonstrate the cause of the pain in these patients. This article will describe some of the pathologies, other than appendicitis, that can present as right iliac fossa pain, and that may be seen when scanning a patient for “query appendicitis.”…”

Section: Introductionmentioning

confidence: 99%

Right Iliac Fossa Pain other than Appendicitis

Goudie

2023

Journal of Medical Ultrasound

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Right iliac fossa pain is a common presentation. Although appendicitis is the most common surgical emergency, many other pathologies can have similar presentations and should be considered. This review describes the findings and shows examples of conditions other than appendicitis that should be examined for in a patient who presents with right iliac fossa pain, particularly if the appendix is not seen or seen to be normal.

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“…The advent of USG has greatly helped in correctly diagnosing acute appendicitis in these female patients. 14 Similarly, acute appendicitis diagnosis is quite challenging in elderly patients. Establishing the diagnosis of inflammation of appendicitis can be a real challenge.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Tzanakis and Alvarado scoring system in diagnosis of acute appendicitis, with Histopathology as gold standard

Iqbal

Ahmed

Malik

et al. 2022

JRMC

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Objective: To determine the diagnostic accuracy of Tzanakis and Alvarado score for the diagnosis of acute appendicitis taking histopathology as the gold standard. Materials and Methods: It was a Cross-sectional validation study The study was carried out at the emergency department of RMC allied hospital Rawalpindi. The study was completed in eighteen months from 1st May 2016 till 30th Nov 2017. After approval from the ethical committee total of 420 patients fulfilling inclusion criteria from the emergency department of District head Quarter hospital, Rawalpindi was taken. Informed consent was taken from patients or their attendants, and their demographic information like name, age, sex, and address was obtained. Alvarado score and Tzanakis score were calculated (as per operational definition) at the time of admission of the patients. After surgery, the specimen appendix was sent for histopathology in the hospital lab. The diagnosis of the acute appendix was based on a positive histological report which was verified by a pathologist. All the data was entered by a researcher who will collect the data by himself. Results: The mean age of patients in this study was 20.15±7.13 years with 218 (51.9%) males and 202 (48.1%) females. The mean Alvardo score was recorded as 7.22±1.58 with the mean Tzanakis score being 9.64±3.13. The histopathology for diagnosing appendicitis showed positive for 367 (87.4%) patients and negative for 53 (12.6%) patients. The sensitivity of Alvarado score for diagnosing appendicitis, keeping histopathology as the gold standard was 86.92%, specificity was 92.45%, Positive Predictive Value was 98.76%, and Negative Predictive Value was 50.52% and overall diagnostic accuracy was 87.62%. The sensitivity of the Tzanakis score for diagnosing appendicitis, keeping histopathology as the gold standard was 88.83%, specificity was 88.6%, Positive Predictive Value was 98.19%, Negative Predictive Value was 53.41% and overall diagnostic accuracy was 88.81%. Conclusion: The sensitivity of the Tzanakis score was high when compared to the Alvarado score. And specificity was high in the Alvarado score when compared to the Tzanakis score. Moreover, the overall diagnostic accuracy of the Tzanakis score was high when compared to the Alvarado score. SoTzanakis score can be utilized to predict appendix and in the future, we can avoid negative appendectomies.

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Acute Appendicitis

Cited by 3 publications

References 72 publications

Clinical value of total white blood cells and neutrophil counts in patients with suspected appendicitis: retrospective study

Clinical value of total white blood cells and neutrophil counts in patients with suspected appendicitis: retrospective study

Right Iliac Fossa Pain other than Appendicitis

Comparison of Tzanakis and Alvarado scoring system in diagnosis of acute appendicitis, with Histopathology as gold standard

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