Diagnostic value of C-reactive protein as a predictor of complicated appendicitis like perforated/gangrenous appendicitis

Authors

  • Suresh Kumar Choudhary Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan
  • Bhanwar Lal Yadav Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan
  • Shalu Gupta Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan
  • Narender Kumar Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan
  • Somendra Bansal Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan
  • Pradeep Kumar Verma Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan

DOI:

https://doi.org/10.18203/2349-2902.isj20191903

Keywords:

C- reactive protein, Inflammation, Perforated/gangrenous appendicitis

Abstract

Background: Appendicitis is inflammation of appendix. Appendicitis remains the most common abdominal surgical emergency. There is no reliable specific marker for acute appendicitis and its complications. C- reactive protein is an acute phase reactant produced by the liver during the acute inflammation, which rises rapidly in presence of inflammation. CRP is a more sensitive and reliable indicator of inflammatory processes than ESR and leucocyte count. The aim of this study was to evaluate whether CRP predict the severity of appendicitis.

Methods: This study was hospital based, observational study. After history and clinical examination, patient underwent USG whole abdomen. Diagnosis of appendicitis was established. After that patient underwent routine blood investigations including, CRP. After confirming diagnosis of appendicitis, patients underwent appendectomy and biopsy of appendix was sent for histopathological examination.

Results: In our study, CRP value > 6.15mg/L has a sensitivity of 100.0% and a specificity of 54% in predicting complicated perforated or gangrenous appendicitis. The positive predictive value and negative predictive value of CRP were 100% and 61.54%  respectively. The cut off level at around 6mg/dL needs to be handled carefully and a person with high CRP should undergo surgery immediately.

Conclusions: This study clearly suggested that CRP leads to precise prediction of the severity of acute appendicitis for treatment. A person with high CRP should undergo surgery immediately ures.

Author Biographies

Suresh Kumar Choudhary, Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan

GENERAL SURGERY

RESIDENT

Bhanwar Lal Yadav, Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan

General Surgery

Associate Professor

Shalu Gupta, Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan

General Surgery

Professor

Narender Kumar, Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan

General Surgery

Resident

Somendra Bansal, Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan

General Surgery

Assistent Professor

Pradeep Kumar Verma, Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan

General Surgery

Assistent Professor

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Published

2019-04-29

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Original Research Articles