Journal Reading

“Diagnostic markers in acute

appendicitis”

Oleh :
Zella Novi Rahmaningrum
(J510170076)

KEPANITERAAN KLINIK ILMU BEDAH

RSUD HARJONO PONOROGO
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH SURAKARTA
2017
BACKGROUND

An adequate Diagnosis of
medical history + acute
Clinical examination appendicitis

gynecological
pathology
variability in appendicular locations  hidden
or retrocecal appendicitis

Several Scoring systems  (Alvaredo, Lintula

and RIPASA)

elevated inflammatory markers (white cell

count (WCC) and C-reactive protein (CRP))
 Sensitivity of
Serum Perforate 70%,
bilirubin appendicitis Specificity of
86%

(Sand M, Bechara FG, Holland-Letz T, et al, 2009)

PATIENTS AND METHODS

• Retrospective analysis  all consecutive patients who underwent

appendicectomy at their institution over a 3-year period (from
January 2007 to April 2010)

Appendicitis
Appendicec
tomy
Laparoscopic
appendicecto
my

Search terms
Inclusion criteria

Age

Sex

Blood test results (WCC, differential leukocytes

count, CRP, and liver function tests including
bilirubin)

Appendix histology
Exclusion criteria

Incomplete blood test result

Known liver disease

Gilbert’s syndrome

Persistently elevated liver function tests

 • Above the upper limits of the
Blood result (+)
hospital’s laboratory values

• bilirubin levels of greater than 15

Hyperbilirubinemia
mmol/L

Leukocytosis • WCC of greater than 11 x 109/L

• Elevated if levels were more than 10

CRP
mg/L
 first group • negative appendicectomy 
(control group) normal appendix on histology

• appendicitis proven on histology

second group without evidence of perforation

third group • appendicular perforation

RESULTS
COMMENTS
CONCLUSION

The diagnosis of appendicitis remains multifactorial and blood tests

may help to guide the surgeon in the decision making.