A Study on the Role of C-Reactive Protein in Minimizing Negative Appendectomy in Clinically Diagnosed Cases of Acute Appendicitis.

Abstract

Background: Acute appendicitis is one of the most common surgical emergencies. Its accurate diagnosis is based on careful history, physical examination, laboratory and imaging investigation. C-Reactive protein (CRP) is an acute –phase reactant protein, which rises rapidly in response to tissue injury and inflammation .The aim of the study is to correlate the levels of serum CRP with the histopathology of the removed appendix. The study also emphasises minimizing the rate of negative appendectomy by using CRP in clinically diagnosed acute appendicitis.  

Materials and methods: This is a cross-sectional study, conducted in the Department of Surgery in collaboration with the Department of Biochemistry. The study population consisted of 100 clinically diagnosed acute appendicitis patients aged 13-65 years who were undergoing emergency appendectomy from August 2019 to July 2021. Pre-operative blood was sent for CRP estimation; and all the specimen were sent for histopathological evaluation postoperatively.

Results:  The level of CRP increased in case of acute appendicitis and the elevation was observed to correlate with the severity of the disease as the levels increased significantly in cases of a perforated appendicitis ( 62.96 ± 31.20 mg/L vs 200.00 ± 26.45 mg/l; p=<0.001). Serum CRP was also positively correlated with Total leucocyte count and appendicular perforation (p<0.01).

Conclusion: Elevated serum CRP levels support the surgeon’s diagnosis and reducing the possibility of possibility of negative appendectomy and, as such, recommended to include in diagnostic workup of acute appendicitis.

Keywords: appendicitis, C-Reactive protein, total leucocyte count