Background: Appendicitis is a frequent cause of abdominal pain, caused by acute inflammation of the appendix, and occurs in approximately 8 to 10% of the population (over a lifetime). Appendicitis has its highest incidence between the ages of 10 and 30 years. The ratio of incidence in men and women is 3:2 through the mid-20s and then equalizes after age 30. Appendicitis is the most common abdominal surgical emergency and a challenge for the world.
Aims and Objectives: To assess the Importance of clinical, laboratory and imaging parameters in evaluating acute appendicitis.
Materials and Methods: A prospective study of 162 patients who were admitted, Department of Surgery in Mahavir Institute Of Medical Sciences, Vikarabad, during Jan 2020 to July 2021; and underwent appendectomy at ﬁrst presentation. Age of presentation was between 5 years to 35 years. Data collected for each patient included demographics (age and sex), clinical information (duration of symptoms, physical signs at examination on admission to the department of surgery), laboratory tests (WBC and neutrophil counts), results of imaging tests, and pathology results. We compared the pathology reports of 162patients with the preoperative assessment of acute appendicitis.
Results: In One and half year period, 162 children were admitted and underwent appendectomy at first presentation in Department of Surgery for suspected acute appendicitis. The study population included 162 patients 90 males (55.55%) and 72 females (44.44%) who underwent surgery for suspected acute appendicitis. The age at presentation was between 5 years to 35 years. The study population was divided into 2 groups according to the pathology results. Group I consisted of 150 patients (92.6%) diagnosed with acute appendicitis. Group II included 12 (7.4%) patients who had a normal appendix based on pathological examination. No differences were found between acute and normal appendices with regard to clinical complaints. However, laboratory and imaging results showed differences between groups. Fever on admission to hospital was higher in patients with acute appendicitis (37.5 °C ± 0.8 vs. 36.8 °C ± 0.7) as were WBC values (14.5 ± 4.9×10 3/ mL vs. 10.2 ± 3.6 × 10 3 / mL) and neutrophils (75% ± 10.1 vs. 60.0% ± 12.9). Ultra sonogram (USG) was performed in all patients. The appendicular diameter was signiﬁcantly smaller in patients with a normal appendix compared to those with acute appendicitis (0.7 ± 0.08cm vs. 0.9 ±0.2cm, respectively).
Conclusion: USG may be a useful tool for evaluating cases with suspected appendicitis, regardless of age or gender, and should be the first choice of imaging modalities. The results of laboratory tests (WBC, Neutrophils) and Imaging (USG) contributed far more than clinical parameters to the accurate diagnosis of acute appendicitis. When these 3 parameters were positive, the probability of normal appendix was less than 1%. The contribution of USG was particularly high as its results matched the ﬁnal diagnosis.