Diagnostic value of imaging methods in diagnosing acute appendicitis incomparison with leukocyte counts

Abstract

Aim: Acute appendicitis (AA) is the most common cause of acute abdomen. Early diagnosis and treatment are life-saving, as delay leads to high mortality and

morbidity. In this study, we aimed to investigate the diagnostic values of leukocyte count and imaging methods such as CT (Computed tomography) and USG

(Ultrasonography) for patients pre-diagnosed with AA.

Material and Methods: A retrospective study included 425 patients who admitted to the emergency room with abdominal pain and operated for pre-diagnosis

of AA.

Results: The patients were divided into groups by appendix histopathology: Group I included 53 patients (12.5%) with a normal appendix, Group II included 289

patients (68%) with noncomplicated appendicitis, and Group III included 83 patients (19.5%) with complicated appendicitis. Two hundred sixty-three patients

were male (61.8%), 162 (32.8%) were female, and their mean age was 34.7 (18-82) years. In AA diagnosis, the sensitivity and specificity of leukocyte count

were 81.45% and 45.2%, respectively, while USG had a sensitivity of 95% and specificity of 84%, and CT had a sensitivity of 86% and specificity of 59%. There

was a significant difference between groups I-II and II-III in terms of leukocyte count (p<0.001) in determining the severity of AA.

Discussion: When diagnosing AA, radiological methods such as USG and CT are also used along with physical and laboratory examinations. Since CT is an

expensive and difficult-to-access method using contrast materials, USG should be the first radiological method as it has acceptable sensitivity and specificity.

To render USG accessible, emergency medical or general surgical specialization training should incorporate emergency USG training.

,Keywords

Acute Appendicitis; Leukocyte; Ultrasonography; Computed Tomography