Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of general surgery

Background: In both industrialised and developing countries, acute appendicitis is the most common cause of non-traumatic acute abdomen. The patient may have non-specific abdominal pain or classic signs of right iliac fossa pain, tenderness, and rebound tenderness on examination.According to statistics, out of every five cases of appendicitis, one is misdiagnosed, and 15% to 40% of individuals who undergo emergency appendectomy have a normal appendix revealed. The aim of this study is to compare the results of total leucocytic count and pelviabdominal ultrasonography findings in determining whether an acute appendicitis is complicated or not. Methods: A case series prospective study carried out on 80 patients different age groups (15- 60) diagnosed as acute appendicitis evidenced by clinical assessment ,laboratory investigations &imaging (Ultrasound examination) admitted in the emergency department of Cairo University Hospitals(KasrAlAiny) , from March 2021 to September 2021.Preoperative TLC and Pelviabdominal ultrasound was done for all patients.All cases were observed for their intraoperative findings.Results: The current study combining pelviabdominal collection (US diagnosis) and TLC of more than 12.95cells/mm3 showed a sensitivity of 37.5% and a high NPV of 70.15%, with the specificity of 97.9% and PPV of 92.31%, and accuracy of 73.75%. Conclusion:A high TLC (>12.95 cells/mm3 ) can raise the suspicion of complicated acute appendicitis. Incorporation of the abdominal US would increase the likelihood of complicated acute appendicitis. Therefore, the surgical intervention decision vs medical treatment can be taken with minimal drawbacks. Moreover, fluid collection in the RIF and/or pelvis can be suspected with a high rise of TLC and confirmed by the abdominal US, thus increasing the likelihood of complicated appendicitis

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