Patients with Clinical Acute Appendicitis Should have Pre-operative Full Blood Count and C-Reactive Protein Assays

INTRODUCTIONThe role of inflammatory markers in the diagnosis of acute appendicitis has not been clearly defined. The aims of this prospective audit were to define the role of the serum markers of inflammation total white cell count, neutrophil count and C-reactive protein in the diagnosis of acute appendicitis with particular reference to the discrimination between uncomplicated and complicated appendicitis, and the prediction of abscess. PATIENTS AND METHODSThe author compiled a prospective database over a 13-month period of all appendicectomies performed. After five exclusions (three having no notes for review and two having confounding second morbidity in the presence of a normal appendix), the data relating to 75 patients were analysed. RESULTSIn patients judged on clinical grounds to require laparotomy for suspected acute appendicitis, white cell count and neutrophil count distinguish acute appendicitis from normal appendices when used as categorical variables, though they do not reflect the presenc...