Poster Author of 1 e-Poster
SE-007 - Acute appendicitis, radiological and laboratory findings correlation with surgical diagnosis
Author of 1 Presentation
SE-007 - Acute appendicitis, radiological and laboratory findings correlation with surgical diagnosis
Abstract
Purpose
Acute appendicitis (AA) is one of the most common causes of urgent surgery. AA symptoms overlap with those of other urgent pathologies, in up to 30% of patients and in up to up to 55% of patients can present with atypical symptoms. Misdiagnosis might lead to unnecessary appendectomy. CT has high accuracy however radiation is the main disadvantage. Consequently, it is important to identify other markers or their combinations significant in AA diagnosis.
Material and methods
Retrospective single center review. All patients with an acute appendicitis referral to CT were identified using an in-house database between year 2016 and 2018. Patients’ records were reviewed for clinical and laboratory parameters, and outcomes, CT examinations were reviewed by radiologist.
Results
A total of 464 CT were evaluated out of which 173 (37,3 %) showed AA. 178 patients required surgical intervention. There were 15 negative appendectomies and 9 false negative CT scans. CT showed sensitivity and specificity of 98% and 27%, accuracy of 92%. Mediana of white blood cell count was 11,6*10e9/l (IQR 8,48-14,2*10e9/l), CRP – 30,5 mg/l (IQR 6,63-85,1 mg/l). A significant positive link was observed between CRP, Basophile percentage (BAS), appendix diameter and free fluid on CT and surgical diagnosis. Duration of symptoms had a low correlation with the final surgical diagnosis (p<0,05) and could prognose surgigical diagnosis for 2% (Rrsquare=0,02461).
Conclusion
Laboratory findings, while helpful in routine practice remain unspecific and secondary to CT results. In order to lower the patients exposure to radiation to the further investigation for possible useful markers combinations is needed.