The significance of preoperative white blood cells count and ultrasonography for diagnosis of acute appendicitis

Abstract

Background:Appendicectomy is still the most common surgical procedure; but diagnostic failure may still occur & leads to delay in treatment or negative appendicectomy.
Objectives of this study:to evaluate value of preoperative white blood cells count &ultrasonography in diagnosis of acute appendicitis Patients and methods:This study had been carried on 588 cases of acute appendicitis. Appendicectomy done for all cases. Over period of 4 years from January 2006-january 2010. the range of age was between 7-76 years. With mean age of (41.5 years).and median age 25 years old. 366 males (62.244%) and 222 females (37.755). ultrasonography done for all patients by our radiologists. white blood cells count performed in our lab. Results:Negative appendicectomy rate was 102 patients (17.346%) this rate was 42 patients (11.475%) for male and 60 patients (27.027%) for female patients. positive appendicitis in 486 Increase white blood cells count for acute appendicitis (histological positive result) in 388 patients (79.835%) from the 486 patients. And increase white blood cells count for non-acute appendicitis (i.e. negative histological result) in 52 patients (50.980) from the 102 patients.
Conclusion:In spite of the improvement tests for acute appendicitis we could not sufficiently reduce the negative appendicectomy rate. If there is doubt about the diagnosis although leukocyte levels and altrasonographic result are normal, especially for female patients performing further radiologic examination such as CT can be favorable.