Leukocytosis in Appendicitis in Older Persons

Hubbell, David S.

doi:10.1001/jama.1961.63040020034017b

Cited by 13 publications

(3 citation statements)

References 7 publications

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“…If undue importance had been attributed to this haematological screen when contradictory to the clinical findings, it would lead to delayed or inappropriate management. That a normal white count may be associated with acute appendicitis in a significant number of patients has been demonstrated in previous studies 1 , 3 , 4 . We have not found the white count to be of value in dealing with an individual patient but a leucocytosis associated with a neutrophilia does add confidence to a clinical diagnosis already established.…”

Section: Discussionmentioning

confidence: 40%

An evaluation of the clinical value of the leucocyte count and sequential counts in suspected acute appendicitis

Lyons

O’Malley

1987

Int J Clinical Practice

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Section: Discussionmentioning

confidence: 40%

An evaluation of the clinical value of the leucocyte count and sequential counts in suspected acute appendicitis

Lyons

O’Malley

1987

Int J Clinical Practice

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“…Although leucocytosis is common, a normal total WBC count is present in up to 50% of patients with acute appendicitis. [11][12][13] About 14.58 % patients had acute appendicitis with normal total WBC count in our study. Thus a normal total WBC count does not rule out the diagnosis of acute appendicitis straightaway.…”

Section: Discussion and Conclusion:-mentioning

confidence: 53%

Acute Appendicitis With Normal Total WBC Counts, a Single Centre Experience.

Rayees¹,

Kashmir²

2019

IJAR

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Background: Acute appendicitis is the most common general surgery emergency. Prompt diagnosis minimizes morbidity and mortality. Historically the diagnosis would be clinical. One of the most frequently used laboratory investigation especially in developing regions is the WBC count. Although the total WBC count is elevated in the majority of the patients, normal total WBC count does not rule out acute appendicitis. Materials and methods: A prospective study of patients who underwent emergency appendectomy at our hospital for suspected acute appendicitis between January 2018 and December 2018 was carried out. Patients were studied with respect to preoperative complaints, clinical examination findings, laboratory and imaging results. Patients were specifically analyzed with respect to total and differential WBC counts. Patients with histopathologically confirmed appendicitis were divided into two groups, one with normal and the other with elevated total WBC counts. Results were analyzed and statistical significance determined. Results: A total of 386 patients underwent an emergency appendectomy for presumed appendicitis between January 2018 and December 2018. 377 patients were found to have acute appendicitis, simple or complicated on exploration, subsequently verified on histopathology. The total WBC count was found to be normal in 55 patients (14.58%) as compared to elevated total WBC counts found in 322 patients (85.41%). Polymorphonuclear leucocytes were more than 75% in 52 of the patients (94.54 %) with normal total WBC counts. The same was found in 306 (95.03 %) patients with elevated total WBC counts. Conclusion: A normal total WBC count does not rule out the diagnosis of acute appendicitis straightaway. The differential WBC count seems to be a more important predictor of acute appendicitis than the total WBC count alone.

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“…Surprisingly, in four‐fifths of these elderly patients there was a good or excellent leukocyte response to infection. Hubbell and associates (1) found that 30 per cent of such patients past the age of 50 had a leukocyte count below 10,000 per cu. mm.…”

Section: Leukocyte Countmentioning

confidence: 99%