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Diagnostic value of C-reactive protein in children with perforated appendicitis
1Department of Paediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan, ROC.
Insights
Diagnosing perforated appendicitis in children is crucial. Elevated serum C-reactive protein (CRP) levels and abdominal ultrasonography significantly aid in identifying this serious condition.
Area of Science:
- Pediatric Surgery
- Diagnostic Imaging
- Clinical Pathology
Background:
- Appendicitis is a common surgical emergency in children.
- Perforation is a frequent complication, particularly in younger children.
- Accurate and timely diagnosis is essential for effective treatment.
Purpose of the Study:
- To evaluate the diagnostic utility of serum C-reactive protein (CRP) levels.
- To assess the role of abdominal ultrasonography in diagnosing perforated appendicitis in children.
- To compare CRP levels and leucocyte counts in children with simple versus perforated appendicitis.
Main Methods:
- Prospective study of 78 children with histologically confirmed appendicitis.
- Patients divided into perforated (Group A, n=56) and simple appendicitis (Group B, n=22) groups.
- Serum CRP levels, leucocyte counts, and abdominal ultrasonography were analyzed.
Main Results:
- Group A patients were significantly younger (mean 7.5 vs. 10.4 years).
- Mean serum CRP levels were significantly higher in Group A (92 vs. 31 mg/l).
- Leucocyte counts were comparable; ultrasonography correctly diagnosed appendicitis in 97% of cases.
Conclusions:
- Perforation is common in pediatric appendicitis, especially in young children with prolonged symptoms.
- Significantly elevated serum CRP levels (≥50 mg/l) are indicative of perforation.
- Abdominal ultrasonography is a valuable tool for diagnosing perforated appendicitis in children.
Unlabelled:
The diagnostic value of serum C-reactive protein (CRP) levels in children with perforated appendicitis was prospectively studied in 78 consecutive patients with histologically confirmed appendicitis. The patients were divided into two groups: group A included 56 patients with perforated appendicitis and group B consisted of 22 patients with simple appendicitis. Serum CRP level and leucocyte count were assayed in all and abdominal ultrasonography was performed in 75. The mean age group A patient was significantly lower than that of group B patients (7.5 vs. 10.4 years, P < 0.001). Group A patients had a significantly higher mean serum CRP levels than group B patients (92 vs. 31 mg/l, P < 0.001), while the mean leucocyte count was comparable in the two groups. Of 75 examined patients, 73 (97%) had a pre-operative sonographic diagnosis of appendicitis.
Conclusion:
Perforation is a common complication in children with appendicitis, especially in those of young age and with prolonged pain duration. Greatly increased serum CRP levels (> or = 50 mg/l) and abdominal ultrasonography are important diagnostic aids in such patients.