[Ultrasonographic findings and evaluation of white blood cell counts in patients undergoing laparotomy with the diagnosis of acute appendicitis].
BACKGROUND
Acute appendicitis (AA) is one of the most frequent pathologies among surgical illnesses. Diagnosis is easy in typical cases, but difficult in atypical cases. In this study, ultrasonographic (USG) findings and leukocyte counts of patients were examined to determine their values in the diagnosis of AA.


METHODS
Data for 85 patients seen in the first six months of 2006 were examined retrospectively. Histopathological diagnosis together with leukocyte counts and USG findings were compared, and sensitivities in the diagnosis were determined.


RESULTS
The average age of the patients was 33.5, and 44.7% were female. In 95.3% of the patients, leukocyte counts were 10000/mm3 and above. In 74.1% of the patients (63 patients), USG was performed, and 58.7% of the cases (37 patients) were compatible with AA. In four (4.7%) of the patients, AA was not found histopathologically (negative laparotomy). The sensitivity of leukocyte counts (> or =10000/mm(3)) was 98.8% and its selectivity was 75%. The sensitivity of USG was 61.0% and its selectivity was 75%. When the areas under the receiver operating characteristics (ROC) curve were compared, leukocyte counts were more sensitive in determining the diagnosis.


CONCLUSIONS
In this study, the sensitivity of USG was lower than the high sensitivity ratios reported in the literature. However, the sensitivity of leukocyte counts was significantly higher than that of USG.
Departments of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.
Ahmet
A
Demircan
Gülbin
G
Aygencel
Mehmet
M
Karamercan
Mehmet
M
Ergin
Tonguç Utku
TU
Yilmaz
Ahmet
A
Karamercan
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000097:blood / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography