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The diagnostic values of preoperative laboratory markers in children with complicated appendicitis

Hany Noh1, Sei-Jin Chang, Airi Han

  • 1Department of General Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.

Journal of the Korean Surgical Society
|October 24, 2012
PubMed

Insights

Pediatric appendicitis diagnosis is improved using common lab tests. Elevated white blood cell (WBC) count, C-reactive protein (CRP), and bilirubin levels help identify complicated appendicitis in children, enabling faster treatment.

Area of Science:

  • Pediatric Surgery
  • Emergency Medicine
  • Clinical Diagnostics

Background:

  • Acute appendicitis is a common surgical emergency in children.
  • Delayed diagnosis in pediatric patients often results from nonspecific symptoms and communication challenges, leading to complicated cases.

Purpose of the Study:

  • To investigate the diagnostic significance of common laboratory markers for acute appendicitis in pediatric patients.
  • To assess the role of white blood cell (WBC), C-reactive protein (CRP), and bilirubin in differentiating simple from complicated appendicitis.

Main Methods:

  • Retrospective analysis of 421 pediatric patients (≤15 years) who underwent appendectomy.
  • Evaluation of preoperative levels of WBC, CRP, and bilirubin.
  • Classification of appendicitis into simple or complicated based on postoperative histology.

Main Results:

  • Patients with complicated appendicitis were younger (P = 0.005).
  • Significantly higher WBC, CRP, and bilirubin levels were observed in the complicated appendicitis group (P < 0.001 for WBC and CRP, P = 0.002 for bilirubin).
  • Elevated CRP (HR, 2.53) and WBC (HR, 2.42) showed the highest risk for complicated appendicitis, with WBC (95.2%) and CRP (86.3%) demonstrating high sensitivity.

Conclusions:

  • Younger age (<10 years) is associated with a higher risk of complicated appendicitis.
  • Preoperative WBC, CRP, and bilirubin levels are valuable clinical tools for diagnosing complicated appendicitis in pediatric patients.
  • Utilizing these markers can facilitate prompt diagnosis and optimize management for pediatric appendicitis.
Abstract

Keywords:
AppendicitisBilirubinC-reactive proteinChildLeukocytes

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