Are Average Platelet Volume (MPV), Red Cell Distribution Width (RDW) and Platelet Distribution Width (PDW) Guiding Markers for Acute Appendicitis Treatment Options?

Abstract

Background: Acute appendicitis (AA) is the most common cause of surgery performed for acute abdomen. The standard treatment for AA patients has been appendectomy for more than a century. use of broad-spectrum antibiotics, the medical treatment option has come to the fore in the treatment of uncomplicated AA. Aim: Evaluate whether WBC, platelet count, MPV, PDW, RDW, and C-reactive protein (CRP) values of patients diagnosed with uncomplicated AA clinically, with laboratory tests and radiologically with abdominal CT could be a marker for choosing medical or surgical treatment. Material and Method: 519 patients aged between 20 and 65 years who were diagnosed with uncomplicated AA by abdominal CT in our centre between January 2016 and January 2019 were retrospectively analysed. . The presence of at least one of the criteria of 7 mm or more appendix diameter and oedema or fluid accumulation around the appendix was accepted as uncomplicated AA. After the diagnosis of AA, 223 patients were treated medically, while 296 patients underwent laparoscopic appendectomy. The first group included patients who were treated medically and the second group included patients who underwent laparoscopic appendectomy. Results: Group 2 patients had higher mean platelet count (p <.005) and RDW (p = .003) values compared to Group 1 patients, while mean PDW (p <.001) values were lower compared to those of Group 1 patients. The differences between the mean WBC, CRP and MPV values of the groups were not statistically significant (p>0.05). Conclusions: The standard treatment for acute appendicitis is surgery. Recently, studies supporting antibiotic therapy have been conducted in patients diagnosed with AA. As a result, we think that PDW, RDW, and platelet values in patients diagnosed with uncomplicated AA may be a guide in choosing patients to be treated with surgery or antibiotics. Key Words: acute appendicitis, laparoscopic appendectomy, antibiotic therapy.