The value of 5-hydroxy indole acetic acid measurement in spot urine in diagnosis of acute appendicitis.

Abstract

OBJECTIVE: To assess the role of 5-Hydroxy Indole Acetic Acid (5-HIAA) levels in spot urine in diagnosis of acute appendicitis. DESIGN: A prospective, controlled study. SETTING: Ankara Numune Teaching and Research Hospital, Ankara, Turkey. SUBJECT: Twenty six patients with histologically proven acute appendicitis following appendectomy were included in the study. Control group with consisted of patients prepared for hernia repair in the same duration. In the preoperative period, urine samples were collected from every patient for measurement of 5-HIAA. RESULTS: The study group comprised 26 patients; 15 of those had high urine 5-HIAA levels, whereas 11 patients had values within normal range. None of ten control patients displayed positive test result. The test had 58% sensitivity and 48% specificity. In histopathological examination only two of ten patients with gangrenous appendicitis showed positive test result, whereas 13 of 16 patients with no histopathological gangrenous changes had high values. CONCLUSION: Urine 5-HIAA measurement has low sensitivity and specificity. The value of the test is even clearly lower in gangrenous appendicitis. This may be misleading in management of patients in late phase of appendicitis and in cases with perforation which is mainly responsible for morbidity.