CLINICAL VS LABORATORY PARAMETER IN DIAGNOSIS OF ACUTE APPENDICITIS
Sunit Agrawal*, Bhawani Khanal, Dipendra Thakur, Vikas Adil, Raj Kumar Sangroula and Ashok Koirala
ABSTRACT
Introduction: Acute appendicitis is one of the most frequent causes of acute abdominal pain often requiring
surgical intervention. The condition is often difficult to diagnose especially during the early stages when the
classical signs and symptoms are usually subtle .Therefore, an ideal diagnostic method or a combination of
laboratory and clinical methods provides adequate information for proper treatment planning. Methods: A total of
100 patients were enrolled in this study following the Ethical approval. All the parameters like age, sex,
demographic data including clinical parameters (migratory pain, anorexia, nausea/vomiting, fever, tenderness and
rebound tenderness) and Laboratory parameters [Total Leucocyte Counts (TLC) and Ultrasonography (USG) of
Abdomen and Pelvis] were entered to predesigned proforma and data was analyzed using SPSS software version
23. Confirmatory diagnosis of acute appendicitis was made by histopathological examination (HPE) report.
Result: The mean age in our study population was 33.3 years. The male to female ratio was 3:2. Migration pain
and tenderness was found in 100% of the participants. Leukocytosis was found in 30% of the participants. USG
had sensitivity and specificity of 85.6% and 40% respectively in diagnosis of acute appendicitis in our study. Of
the variables only TLC was significantly associated with HPE with p-value of 0.022. Conclusion: The main
findings of our study confirmed improved diagnostic accuracy of combined clinical and laboratory parameters in
the diagnosis of AA in the adult emergency population, compared to clinical or laboratory parameters alone.
Keywords: Acute appendicitis, pain, total leucocyte counts (TLC), ultrasonography (USG),
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