Elevated C-reative protein (CRP) as a surgical indication for appendicitis

Abstract

Objective: Role of C-reactive protein value in the diagnosis of appendicitis by correlating with severity of appendicitis on histopathological findings.

Methodology: This descriptive study was conducted at the department of general surgery Unit-IV, Liaquat University Hospital Hyderabad from March 2016 to February 2017.

All cases above 12 years of age with severe appendicitis based on presenting signs and symptoms were included. The patient underwent routine laboratory investigations including abdominal plain x-ray in an erect position and ultrasound abdomen. The blood sample was taken from each patient for C-reactive protein and was send to Hospital diagnostic laboratory. During surgery, a specimen of each patient was sent to a diagnostic laboratory for histopathology. All the data were record on Performa.

Results: A total of 305 patients were studied; their mean age was 35.7+9.7 years. Males were found in the majority (73%). 75.41% of patients had leukocytosis. C-reactive protein was raised among 26.22% of patients. On histopathological findings, 04.91% of patients had a normal appendix, while 69.83% had gross inflammation of the appendix, 19.67% patients had gangrenous appendix, and 05.57% patients had perforation and peritonitis. Elevated C reactive protein (CRP) and leukocytosis were significantly associated with the severity of appendicitis, p value 0.001.

Conclusion: C-reactive protein is a non-invasive and reliable indicator for surgical treatment of appendicitis. C-reactive protein and white blood cells (WBCs) were significantly associated with the severity of appendicitis.