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The effect of appendix diameter on perforation in acute appendicitis cases

Year 2019, , 392 - 397, 30.06.2019
https://doi.org/10.7197/223.vi.567892

Abstract

Objective: The aim of the study is to examine the association
between appendix diameter and perforation and to show the significance of
appendix diameter in acute appendicitis cases.

Method: The data of 286 cases who were older than 18 years of
age and who were operated in a tertiary hospital between 2017 and 2018 with a
diagnosis of acute appendicitis were examined retrospectively.
The
patients’ ages, genders, pathology results, appendix diameter at abdominal
tomography, white blood cell (WBC) and C-reactive protein (CRP) values were
analyzed. The patients were grouped in three as perforated, non-perforated and
negative appendectomy group.

Results: Of the 286
patients operated with a diagnosis of AA, 166 (58%) were male, while 122 (42%)
were female and average age of the patients was 37±16.79 years. Non-perforated
group consisted of 194 patients, while perforated group consisted of 56
patients and negative appendectomy group consisted of 36 patients. Average
appendix diameter of the patients was 8.84±3.29 mm, while average WBC value was
13071±3726/mm3 and average CRP value was 3.44±5.15mg/L. When the
patients’ appendix diameters and CRP values were compared, statistically
significant difference was found between the groups (p<0.001). Average value
of white blood cell was the lowest in negative appendectomy group, while it was
the highest in perforated group. There was a statistically significant
difference between negative appendectomy group and the other two groups in
terms of white blood cell (p<0.001). There was a positive correlation
between the groups in terms of appendix diameter, white blood cell and CRP  (p<0.001).







Conclusions:
Appendix diameter is important in the diagnosis of
acute appendicitis and detection of perforated appendicitis. Appendix diameter
is correlated with white blood cell and CRP. 

Thanks

We thank radiologist Dr. Serdar Altay for their help in this study.

References

  • Referans1. Sarac M, Bakal Ü, Tartar T, Kazez A. The Role of the Doctors in Perforated Appendicitis. Firat Med J 2014;19:126-29.
  • Referans2. Akay S., Akay H, Vardar E, Erkul Z. Comparison of Eosinophil Values with Other Biomarkers in Predicting Perforation of Acute Appendicitis. Eurasian J Emerg Med 2017; 16: 8-11.
  • Referans3. Aygun A, Katipoglu B, Imamoglu M, Demir S, Yadigaroglu M, Tatli O, et al. Diagnostic Value of Plasma Pentraxin-3 in Acute Appendicitis. J Invest Surg. 2017;11:1-6.
  • Referans4. Mengucuk ME, Ayten R, Bulbuller N, Godekmerdan A, Basbug M, Mungan I. The place of serum C-reactive protein, procalcitonin, and neopterin in the diagnosis of acute appendicitis. Firat Med. J. 2010;15(1):40–43.
  • Referans5. Yildirim O, Solak C, Koçer B, Unal B , Karabeyoglu M , Bozkurt B , et al. The role of serum inflammatory markers in acute appendicitis and their success in preventing negative laparotomy. J Invest Surg. 2006;19:345–352.
  • Referans6. Gokce AH, Aren A, Gokce FS, Dursun N, Barut AY. Reliability of ultrasonography for diagnosing acute appendicitis. Ulus Travma Acil Cerrahi Derg. 2011;17(1):19–22
  • Referans7. Binnebosel M, Otto J, Stumpf M, Mahnken AH, Gassler N, Schumpelick V, et al. Acute appendicitis. Modern diagnostics-surgical ultrasound. Chirurg. 2009 Jul;80(7):579–87.
  • Referans8. Birnbaum BA, and. Wilson SR. Appendicitis at the Millennium. Radiology. 2000; 215:337-348.
  • Referans9. Jaın RK, Jaın M, Rajak CL, Mukherjee S, Bhattacharyya PP, Shah MR. Imaging In Acute Appendicitis: A Review. Ind J Radiol Imag 2006 16:4:523-32
  • Referans10. Raptopoulos V, Katsou G, Rosen MP, Siewert B, Goldberg SN, Kruskal JB. Acute Appendicitis: Effect of Increased Use of CT on Selecting Patients Earlier. Radiology 2003; 226:521-526.
  • Referans11. Kaiser S, Frenckner B, Jorulf HK. Suspected Appendicitis in Children: US and CT- A Prospective Randomized Study. Radiology 2002; 223:633-638.
  • Referans12. Baldisserotto M, Marchiori E. Accuracy of Noncompressive sonography of children with appendicitis according to the potential positions of the Appendix. AJR 2000; 175:1387-1392
  • Referans13. Benjaminov O, Atri M, Hamilton P, and Rappaport D. Frequency of Visualization and Thickness of Normal Appendix at Nonenhanced Helical CT. Radiology 2002; 225:400-406.
  • Referans14. Arévalo O, Moreno M, Ulloa L. Acute appendicitis: imaging findings and current approach to diagnostic images. Rev Colomb Radiol. 2014; 25(1): 3877-88
  • Referans15. Webb EM, Wang ZJ, Coakley FV, Poder L , Westphalen AC , Yeh BM .The equivocal appendix at CT: Prevalence in a control population. Emerg Radiol. 2010;17:57-61.
  • Referans16. Bixby SD, Lucey BC, Soto JA, Theysohn JM, Ozonoff A, Varghese JC. Perforated versus nonperforated acute appendicitis: Accuracy of multidetector CT detection. Radiology. 2006;241:780-786.
  • Referans17. Yu CW, Juan LI, Wu MH, Shen CJ, Wu JY, Lee CC. Systematic review and meta-analysis of the diagnostic accuracy of procalcitonin, C-reactive protein and white blood cell count for suspected acute appendicitis. Br J Surg. 2013;100(3):322–9.
  • Referans18. Shafi SM, Afsheen M, Reshi FA. Total Leucocyte Count, C-reactive protein and neutrophil count: Diagnostic aid in acute appendicitis. Saudi J Gastroenterol. 2009;15(2):117-20.
  • Referans19. McGowan DR, Sims HM, Zia K, Uheba M, Shaikh IA. The value of biochemical markers in predicting a perforation in acute appendicitis. ANZ journal of surgery 2013:83(1-2); 79-83.
Year 2019, , 392 - 397, 30.06.2019
https://doi.org/10.7197/223.vi.567892

Abstract

References

  • Referans1. Sarac M, Bakal Ü, Tartar T, Kazez A. The Role of the Doctors in Perforated Appendicitis. Firat Med J 2014;19:126-29.
  • Referans2. Akay S., Akay H, Vardar E, Erkul Z. Comparison of Eosinophil Values with Other Biomarkers in Predicting Perforation of Acute Appendicitis. Eurasian J Emerg Med 2017; 16: 8-11.
  • Referans3. Aygun A, Katipoglu B, Imamoglu M, Demir S, Yadigaroglu M, Tatli O, et al. Diagnostic Value of Plasma Pentraxin-3 in Acute Appendicitis. J Invest Surg. 2017;11:1-6.
  • Referans4. Mengucuk ME, Ayten R, Bulbuller N, Godekmerdan A, Basbug M, Mungan I. The place of serum C-reactive protein, procalcitonin, and neopterin in the diagnosis of acute appendicitis. Firat Med. J. 2010;15(1):40–43.
  • Referans5. Yildirim O, Solak C, Koçer B, Unal B , Karabeyoglu M , Bozkurt B , et al. The role of serum inflammatory markers in acute appendicitis and their success in preventing negative laparotomy. J Invest Surg. 2006;19:345–352.
  • Referans6. Gokce AH, Aren A, Gokce FS, Dursun N, Barut AY. Reliability of ultrasonography for diagnosing acute appendicitis. Ulus Travma Acil Cerrahi Derg. 2011;17(1):19–22
  • Referans7. Binnebosel M, Otto J, Stumpf M, Mahnken AH, Gassler N, Schumpelick V, et al. Acute appendicitis. Modern diagnostics-surgical ultrasound. Chirurg. 2009 Jul;80(7):579–87.
  • Referans8. Birnbaum BA, and. Wilson SR. Appendicitis at the Millennium. Radiology. 2000; 215:337-348.
  • Referans9. Jaın RK, Jaın M, Rajak CL, Mukherjee S, Bhattacharyya PP, Shah MR. Imaging In Acute Appendicitis: A Review. Ind J Radiol Imag 2006 16:4:523-32
  • Referans10. Raptopoulos V, Katsou G, Rosen MP, Siewert B, Goldberg SN, Kruskal JB. Acute Appendicitis: Effect of Increased Use of CT on Selecting Patients Earlier. Radiology 2003; 226:521-526.
  • Referans11. Kaiser S, Frenckner B, Jorulf HK. Suspected Appendicitis in Children: US and CT- A Prospective Randomized Study. Radiology 2002; 223:633-638.
  • Referans12. Baldisserotto M, Marchiori E. Accuracy of Noncompressive sonography of children with appendicitis according to the potential positions of the Appendix. AJR 2000; 175:1387-1392
  • Referans13. Benjaminov O, Atri M, Hamilton P, and Rappaport D. Frequency of Visualization and Thickness of Normal Appendix at Nonenhanced Helical CT. Radiology 2002; 225:400-406.
  • Referans14. Arévalo O, Moreno M, Ulloa L. Acute appendicitis: imaging findings and current approach to diagnostic images. Rev Colomb Radiol. 2014; 25(1): 3877-88
  • Referans15. Webb EM, Wang ZJ, Coakley FV, Poder L , Westphalen AC , Yeh BM .The equivocal appendix at CT: Prevalence in a control population. Emerg Radiol. 2010;17:57-61.
  • Referans16. Bixby SD, Lucey BC, Soto JA, Theysohn JM, Ozonoff A, Varghese JC. Perforated versus nonperforated acute appendicitis: Accuracy of multidetector CT detection. Radiology. 2006;241:780-786.
  • Referans17. Yu CW, Juan LI, Wu MH, Shen CJ, Wu JY, Lee CC. Systematic review and meta-analysis of the diagnostic accuracy of procalcitonin, C-reactive protein and white blood cell count for suspected acute appendicitis. Br J Surg. 2013;100(3):322–9.
  • Referans18. Shafi SM, Afsheen M, Reshi FA. Total Leucocyte Count, C-reactive protein and neutrophil count: Diagnostic aid in acute appendicitis. Saudi J Gastroenterol. 2009;15(2):117-20.
  • Referans19. McGowan DR, Sims HM, Zia K, Uheba M, Shaikh IA. The value of biochemical markers in predicting a perforation in acute appendicitis. ANZ journal of surgery 2013:83(1-2); 79-83.
There are 19 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Surgical Science Research Articles
Authors

Burak Katipoglu 0000-0002-4347-6258

Ali Aygun 0000-0002-5190-1445

Hamza Çınar 0000-0003-1748-1392

Publication Date June 30, 2019
Acceptance Date June 24, 2019
Published in Issue Year 2019

Cite

AMA Katipoglu B, Aygun A, Çınar H. The effect of appendix diameter on perforation in acute appendicitis cases. CMJ. June 2019;41(2):392-397. doi:10.7197/223.vi.567892