Role of Total Leukocyte Count and C-Reactive Protein In Diagnosis of Acute Appendicitis

Dr. Lavu Venkatesh, Dr. D. Lokanadham

Abstract: Introduction: Acute appendicitis is a common surgical emergency with variable presentations, making diagnosis challenging. Despite advances in diagnostic modalities, the diagnosis remains doubtful in 30-40% of cases. This study investigates the role of TLC and CRP in diagnosing acute appendicitis. Methods: The study included 75 patients diagnosed with acute appendicitis, with data collected from January 2024 to July 2024. Patients above 12 years of age with symptoms and signs of acute appendicitis were enrolled, while those with extreme age, pregnancy, immunocompromised status, and pre-existing diseases were excluded. TLC and CRP levels were evaluated in all patients, and appendectomies were performed independently of these results. Results: 1) Among 56 inflamed appendix cases, CRP was raised in 46 (82.14%) cases and normal in 10 (17.86%) cases. 2) Among 56 inflamed appendix cases, TLC was raised in 43 (76.79%) cases and normal in 13 (23.21%) cases. 3) Combining TLC and CRP showed better significance than individual tests, with a sensitivity of 90.24% and specificity of 78.57%. Conclusion: TLC and CRP are useful in diagnosing acute appendicitis, especially when used in combination. The negative predictive value of 73.33% suggests that deferring surgery in patients with negative TLC and CRP results may reduce unnecessary appendectomies and associated morbidity.

Keywords: acute appendicitis, TLC and CRP, diagnostic accuracy, surgical decision-making, clinical biomarkers