The Value of C-Reactive Protein in Enhancing Diagnosis of Acute Appendicitis

Abstract

Background: Acute appendicitis is one of the most common surgical emergencies. Accurate diagnosis of acute appendicitis is based on careful history, physical examination, laboratory and imaging findings. The aim of this study was to analyze the role of C-reactive protein (CRP) in improving the accuracy of diagnosis of acute appendicitis and to compare it with the histopathology findings. Methods: A retrospective study of 100 patients aged between 7 and 69 years who presented to the A&E in 2013 - 2014, in whom the diagnosis of appendicitis was the attending physician’s primary consideration, was conducted. Measures included age, gender, initial CRP counts, and discharge diagnosis. Based on histology, appendicitis was classified as simple (inflammation) or complicated suppurative, gangrenous, necrotizing perforation. Results: Out of 100 patients, 32% were classified as an inflamed appendicitis. Of the patients, 34% were shown to have suppurative appendicitis, 17% gangrenous, 13% perforated, and 5% necrotizing. Very high CRP is likely to be associated with necrotizing appendicitis, while CRP of 40 or more can be associated with suppurative or inflammatory one. CRP more than 100 and less than 150 may suggest possible perforated or gangrenous appendicitis. Conclusion: Our data provided provisional evidence that very high CRP may be related to necrotizing appendicitis, while CRP above 40 mg/L may suggest suppurative or inflammatory appendicitis. Keywords: CRP; Appendicitis