Original articlePredictive value of white blood cell count and C-reactive protein in children with appendicitis
Section snippets
Patients and methods
From August 2004 to December 2005, we studied prospectively 198 consecutive pediatric patients (<15 years of age) who underwent appendectomies for suspected appendicitis at our institution. On admission, we recorded data including age, sex, time from the onset of symptoms to diagnostic (evolution), WBC counts, CRP levels, and after discharge from the hospital, the histological report of the resected appendix. The diagnosis was principally established on clinical grounds. In some patients, we
Results
Groups were comparable in terms of sex, age, and hours of evolution. White blood cell counts and CRP levels were significantly higher in patients with appendicitis (Table 1). Patients with normal appendix had similar demographical parameters, WBC counts, and CRP levels. Patients with appendicitis with more than 49 hours from the onset of symptoms to diagnosis were older than patients with less hours of evolution. White blood cell counts were higher for patients with more than 49 hours of
Discussion
The classic clinical picture of acute appendicitis has been widely known for more than 110 years [10]; however, it has been mostly described in adult patients. In addition, some atypical symptoms that could lead to errors in the diagnosis of appendicitis have also been described mainly in young adults and children [10], [11]. The problem with the erroneous diagnosis of appendicitis is that the removal of a normal appendix or on the contrary the delay in treatment of appendicitis associated to
Conclusions
White blood cell counts and CRP levels are reliable inflammatory markers that could be used to support the clinical diagnosis of appendicitis and, depending on the time from the onset of symptoms to diagnosis, could differentiate patients with and without appendicitis and discriminate simple appendicitis from perforated appendicitis in children.
References (22)
- et al.
The treatment of complicated appendicitis in children undergoing peritoneal drainage: results from a public hospital
J Pediatr Surg
(1993) - et al.
Perforated appendicitis in children: risk factors for the development of complications
Surgery
(1998) - et al.
Acute appendicitis in children: emergency department diagnosis and management
Ann Emerg Med
(2000) - et al.
Accuracy of leukocyte count in the diagnosis of acute appendicitis
Ann Emerg Med
(1999) - et al.
Predictive value of C-reactive protein at different cutoff levels in acute appendicitis
Am J Emerg Med
(2005) A practical score for the early diagnosis of acute appendicitis
Ann Emerg Med
(1986)- et al.
Application of a clinical score for the diagnosis of acute appendicitis in children: a retrospective analysis of 197 patients
J Pediatr Surg
(2000) Pediatric appendicitis score
J Pediatr Surg
(2002)- et al.
Can perforated appendicitis be diagnosed preoperatively based on admission factors?
J Gastrointest Surg
(2000) - et al.
Can ruptured appendicitis be detected preoperatively in the ED?
Am J Emerg Med
(2005)
Which children could benefit from additional diagnostic tools in case of suspected appendicitis?
J Pediatr Surg
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