Role of C-reactive protein in enhancing the diagnosis of acute appendicitis

Authors

  • Raheel Hussan Naqvi Department of Surgery, Government Medical College, Jammu, Jammu and Kashmir, India
  • Abhinav Mani Department of Surgery, Government Medical College, Jammu, Jammu and Kashmir, India
  • Sahil Rometra Department of Surgery, Government Medical College, Jammu, Jammu and Kashmir, India
  • Gurbir Singh Department of Surgery, Government Medical College, Jammu, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2349-2902.isj20220638

Keywords:

Acute appendicitis, CRP, Histopathology

Abstract

Background: Acute appendicitis is one of the common surgical emergencies. This study analysed C- reactive protein as a diagnostic marker of acute appendicitis.

Objective of the current study was to investigate the efficacy of C-reactive protein in the diagnosis of acute appendicitis.

Methods: A prospective study done on patients coming to hospital with clinical diagnosis of acute appendicitis and underwent appendectomy. Operative and histopathological findings were compared and analyzed with C- reactive protein.

Results: A total of 100 patients were included in the study. CRP was more than 6mg/l in 89 patients, and out of 89 patients, 87 patients had histopathologically inflamed appendix and serum CRP estimation in diagnosis of acute appendicitis yield sensitivity of 90.6%, specificity of 50%, positive predictive value of 97.75% and negative predictive value of 18.2%.

Conclusions: CRP was raised in patients with acute appendicitis and it aids as a marker for diagnosing acute appendicitis and decreasing the rate of negative appendectomy.

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Published

2022-02-28

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Original Research Articles