A study on C-reactive protein as a diagnostic parameter in acute appendicitis: A double blind study

Abstract

Background: Although appendicectomy is the most commonly done emergency surgery still its diagnosis remains an enigmatic challenge, with persisting high rate of negative explorations. Objective: The objective of the study was to evaluate the role of accuracy of CRP measurement in the diagnosis of acute appendicitis and to reduce the morbidity by avoiding negative exploration. Methods: The present study was conducted in 40 patients who have been clinically diagnosed by Surgeon’s as having acute appendicitis and posted for emergency appendicectomy in General Surgery Department, Glocal Medical College & Super Specialty Hospital. Preoperatively blood was sent for CRP estimation, after operation, all specimens were sent for histopathological examination, results of CRP were correlated with HPE reports to evaluate their role in diagnosis of acute appendicitis. Results: In present study, CRP has highest sensitivity and specificity of 97.5% and 85% with positive predictive value of 96%. Hence it was proved that CRP level can be used to rule out negative appendicitis, so that surgery can be deferred in them and to reduce rate of negative appendicectomies. Conclusion: We continue to stress that history and clinical examination by a skilled surgeon still remain indispensible in diagnosing acute appendicitis, and its importance cannot be under mined. But CRP helps to reduce negative appendicectomy rate drastically and hence should always be included in diagnostic work up of acute appendicitis.