Abstract

Background: Although appendicectomy is the most commonly done emergency surgery
still its diagnosis remains an enigmatic challenge, with persisting high rate of negative
explorations. Objective: The objective of the study was to evaluate the role of accuracy
of CRP measurement in the diagnosis of acute appendicitis and to reduce the morbidity
by avoiding negative exploration.
Materials and Methods: The present study was conducted in 30 patients who have been
clinically diagnosed by Surgeon’s as having acute appendicitis and posted for
emergency appendicectomy in General Surgery Department, Glocal Medical College &
Super Speciality Hospital. Preoperatively blood was sent for CRP estimation, after
operation, all specimens were sent for histopathological examination, results of CRP
were correlated with HPE reports to evaluate their role in diagnosis of acute
appendicitis.
Results: In present study, 24 patients had elevated serum CRP level (>2.5 mg/dl) which
is 83.3% of total study group. In these patients only one patient had high serum CRP
level inspite of normal appendix that was proved histologically. The cause of raised
serum level of CRP in this patient was mesenteric lymphadenitis which was found
peroperatively.Hence it was proved that CRP level can be used to rule out negative
appendicitis, so that surgery can be deferred in them and to reduce rate of negative
appendicectomies.
Conclusion: We continue to stress that history and clinical examination by a skilled
surgeon still remain indispensible in diagnosing acute appendicitis, and its importance
cannot be under mined. But CRP helps to reduce negative appendicectomy rate
drastically and hence should always be included in diagnostic work up of acute
appendicitis.