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Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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Appendicitis-I: Introduction01:22

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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
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Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Differentiating Appendicitis Severity: A

Kaijun Li1, Junjie Xiang1, Yuqian Li1

  • 1School of Medicine, Shaoxing University, Shaoxing, Zhejiang, P.R. China.

The Journal of Surgical Research
|December 17, 2025
PubMed
Summary

The neutrophil-to-lymphocyte ratio (NLR) is more effective than the platelet-to-lymphocyte ratio (PLR) in diagnosing complex appendicitis. This finding aids in early clinical decisions for abdominal pain management.

Keywords:
Acute appendicitisDiagnostic valueNeutrophil-to-lymphocyte ratioPlatelet-to-lymphocyte ratio

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Area of Science:

  • Medical Diagnostics
  • Inflammatory Biomarkers
  • Gastroenterology

Background:

  • Acute appendicitis diagnosis requires distinguishing simple from complex forms for effective treatment.
  • Current diagnostic methods like imaging and scoring systems have limitations in accuracy.
  • Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are emerging as accessible inflammation markers.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of NLR and PLR in differentiating simple from complex appendicitis.
  • To assess the effectiveness of these ratios across different age groups (pediatric and adult).
  • To compare the reliability of NLR versus PLR for clinical decision-making.

Main Methods:

  • Systematic literature search for studies published before May 2025.
  • Meta-analysis of diagnostic accuracy using receiver operating characteristic (ROC) curve analysis.
  • Stratification of results by age group (pediatric and adult).

Main Results:

  • NLR demonstrated a pooled area under the curve (AUC) of 0.76 for complex appendicitis diagnosis in the overall population.
  • Age-stratified analysis showed consistent NLR performance (AUC 0.74) in both pediatric and adult groups.
  • PLR exhibited a lower pooled AUC of 0.67, with pooled sensitivity of 0.58 and specificity of 0.69.

Conclusions:

  • NLR is a more reliable biomarker than PLR for identifying complex appendicitis.
  • The findings support NLR's utility in guiding early clinical decision-making for appendicitis.
  • NLR offers a valuable, cost-effective tool for improving appendicitis diagnosis.