EVALUATION OF SERUM C REACTIVE PROTEIN IN ACUTE APPENDICITIS AND ITS CORRELATION WITH HISTOPATHOLOGY

Background: Acute appendicitis is the most common abdominal surgical emergency, but its diagnosis remains an
enigmatic challenge, plagued by a high rate of negative explorations. There is no single reliable test with satisfactory
sensitivity and specicity. Ultrasonography is not often available at a rural surgical setup. This study is intended to evaluate the importance Aim:
of serum C-reactive protein (CRP) level estimation in diagnosis of acute appendicitis, by comparing with histopathology report. In a Methods:
prospective study,100 patients clinically diagnosed as acute appendicitis were selected by purposive sampling method and evaluated as per
criteria for serum CRP levels, leucocyte count preoperatively and were followed up postoperatively with histopathology reports. The data was
analysed for nding the signicance of serum CRP in the diagnosis of acute appendicitis. CRP was positive in 75 of the 77 patients who Results:
had histologically proven acute appendicitis and in 3 with normal appendix. The sensitivity, specicity and diagnostic accuracy were 97.4%,
86.96% and 95% respectively. Leucocytosis and neutrophilia when used alone were not specic for acute appendicitis, but when combined with
CRP value, diagnostic accuracy was high. Ultrasonography was useful in establishing alternative diagnoses, but had low sensitivity for acute
appendicitis. CRP contains important diagnostic information and hence should always Interpretation & Conclusion: be included in the
diagnostic workup of acute appendicitis. Since acute appendicitis is very unlikely in those patients with normal WBC count and CRP value,
conservative treatment is advised.This study does not undercut the skill of an experienced surgeon in diagnosing acute appendicitis, but CRP
estimation compliments clinical diagnosis.