Abstract

Diagnostic work-up of acute appendicitis remains challenging. While some guidelines advise to use a risk stratification based on clinical parameters, others use standard imaging in all patients. As non-operative management of uncomplicated appendicitis has been identified as feasible and safe, differentiation between uncomplicated and complicated appendicitis is of paramount importance. We reviewed the literature to describe the optimal strategy for diagnosis of acute appendicitis. AIMS AND OBJECTIVE: To Compare analysis between role of USG and biochemical markers in the diagnosis of complicated and uncomplicated appendicitis METHODS AND MATERIALS: The clinical, demographic and laboratory data of patients aged over 65 years were extracted and retrospectively analyzed. Data items included patient sex, age, time from symptom onset to admission, comorbidities, preoperative blood results. Approval was obtained from the Ethics Committee of G.S Medical College and Hospital, Hapur, U.P. The period of study was between 15th May 2022 to 30th Nov 2022. RESULTS: Seventy-one patients had appendicitis, 11 (12.12%) of which were perforated upon histological examination. All biochemical markers were significantly higher in perforation (P < 0.001). The greatest sum of sensitivity and specificity of CRP was at 34.6 mg/L (sensitivity 78.57%, specificity 63.01%), and for bilirubin was at 21.5 mmol/L (sensitivity 62.96%, specificity 88.31%). Combining CRP and bilirubin improved sensitivity and specificity, but this was reduced by further incorporating WCC and neutrophils.

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