Analysis of computed tomography and laboratory indices in patients operated for acute appendicitis

Abstract

Purpose: Evaluation of the efficacy of complete blood count (CBC) parameters and computed tomography (CT) for reduction of negative appendectomy rates was aimed. Materials and methods: One hundred and fifty-three patients operated between December 2015-December 2017 with preliminary diagnosis of acute appendicitis are retrospectively evaluated for sociodemographic variables such as age, gender, preoperative laboratory findings, abdominal CT reports. Results: Median age of the patients operated for preliminary diagnosis of acute appendicitis was 31 (18-76), 33.3% were females and 66.7% were males. Negative appendectomy rate was 15% (23/153). The difference of white blood cell, neutrophil count, neutrophil lymphocyte ratio, plateletcrit, neutrophil percentage values between appendicitis and normal appendix groups according to pathological reports were statistically significant. Abdominal CT results for acute appendicitis with 95% confidence interval was as; sensitivity 97.0% (92.4-99.2), specificity 86.4% (65.1-97.1), positive predictive value (PPV) 97.7% (93.7-99.2), negative predictive value (NPV) 82.6% (64.1-92.7). Conclusion: Acute appendicitis is one of most encountered diseases by surgeons and is hard to diagnose. Cases should be evaluated by anemnesis, physical examination, laboratory findings and imaging as a whole. It is useful to use CT in the diagnosis of appendicitis especially in female patients with high negative appendectomy rates.

Keywords

• acute apendicitis
• negative appendectomy rate
• computed tomography
• sensitivity
• specificity

Akut apandisit nedeni ile opere edilen hastalarda bilgisayarlı tomografi ve laboratuvar değerlerinin analizi

Abstract

Amaç: Negatif apendektomi oranını azaltmada hemogram parametreleri ve bilgisayarlı tomografinin (BT) etkinliğinin değerlendirilmesi amaçlanmıştır. Gereç ve yöntem: Aralık 2015-Aralık 2017 tarihleri arasında apandisit ön tanısı ile ameliyat edilen 153 hasta yaş, cinsiyet gibi sosyodemografik özellikleri, operasyon öncesi laboratuar bulguları, karın BT sonuçları açısından retrospektif olarak incelenmiştir. Bulgular: Apandisit ön tanısı ile opere edilen olguların ortanca yaşı 31(18-76)’dir ve olguların %33,3’ü kadın, %66,7’si erkektir. Bu çalışmada negatif apendektomi oranı %15 (23/153) olarak saptanmıştır. Patoloji sonucu apandisit olan ve normal apendiks olan gruplar arasındaki beyaz küre, nötrofil sayısı, nötrofil lenfosit oranı, plateletkrit, nötrofil yüzdesi değerleri arasındaki farklar istatistiksel olarak anlamlıdır. Karın BT’nin apandisit için %95 güven aralığı ile sensitivitesi %97,0 (92,4-99,2), spesifisitesi %86,4 (65,1-97,1), pozitif prediktif değeri (PPV) %97,7 (93,7-99,2), negatif prediktif değeri (NPV) %82,6 (64,1-92,7)’dir. Sonuç: Akut apandisit cerrahlar tarafından en sık karşılaşılan, tanı konması en zor hastalıklardan biridir. Olgular hikâye, fizik muayene, laboratuar sonuçları ve görüntüleme ile bir bütün olarak ele alınmalıdır. Negatif apendektomi oranlarının yüksek olduğu özellikle kadın hastalarda apandisit tanısında BT kullanılması faydalıdır.

Keywords

• Akut apandisit
• negatif apendektomi oranı
• bilgisayarlı tomografi
• sensitivite
• spesifisite

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