Role of Leucocyte Count in the Diagnosis of Acute Appencicitis

Abstract

Background: The diagnosis of acute appendicitis is difficult and probably the most commonly encountered diagnostic problem in clinical surgery. The aim of the present work was to study the value of pre-operative leucocyte count in patients operated on for a clinical suspicion of acute appendicitis.

Material & Methods: This retrospective study conducted from January to October 2008 in DHQ and Allied Hospital Faisalabad. Five hundred consecutive patients operated in accident and emergency department of DHQ and Allied Hospital Faisalabad with the clinical suspicion of uncomplicated acute appendicitis were included in the study. Leucocyte count was checked before operation and acute appendicitis was confirmed by histological examination.

Results: The increase in leucocyte count was an early marker of acute appendiceal inflammation. In this study, leucocyte count was raised in 79.6% of patients with acute appendicitis. Only 2.4% patients have raised leucocyte count with normal appendix. In 7.6% patients, leucocyte count was normal but appendix was inflamed and in 10.4% patients, both leucocyte count and appendix were normal.

Conclusion: Leucocyte count is an important diagnostic criterion for the diagnosis of acute appendicitis. If it is normal, patient should be further investigated by ultrasonography or diagnostic laparoscopy.