A Hospital Based Prospective Study to Evaluate the Diagnostic Efficacy of Serum CRP Levels in Clinically Diagnosed Cases of Acute Appendicitis Confirm by HPR

Abstract

Background: Acute appendicitis is one of the most common surgical emergencies and the most common source of infection in community-acquired intra-abdominal infections. Several prospective studies have shown that, in adults who have had symptoms for longer than 24 h, a normal CRP level has a negative predictive value of 97-100% for appendicitis. The aim of this study was to analyze the role of C-reactive protein (CRP) in improving the accuracy of diagnosis of acute appendicitis and to compare it with the histopathology findings. Materials & Methods: A hospital based prospective study done on 30 operated patients suspected of acute appendicitis in department of general surgery at district hospital Dholpur, Rajasthan, India during one year period. The normal CRP level in our laboratory is 0–6 mg/L. Levels above 6 mg/L were considered as being above normal.Macroscopic assessment was made from the operation. Appendectomy and a histopathology examination were performed on all patients. Gross description was compared with histopathology results and then correlated with CRP. Results: Out of 30 patients, 9 were classified as an inflamed appendicitis, 10 patients were shown to have suppurative appendicitis, 5 gangrenous, 4 perforated, and two necrotizing. Overall in the inflammation and suppurative groups (group A), the CRP was normal in 6 out of 19 patients. Complicated appendicitis included gangrenous, perforated and necrotizing (group B). CRP was normal in none of patients. Conclusion: We found that elevated serum CRP levels support the surgeon's clinical diagnosis. We recommend CRP measurement as a routine laboratory test in patients with suspected diagnosis of acute appendicitis.