scholarly journals Can Fetuin-A Level, CRP, and WBC be a Predictive Value in the Diagnosis of Acute Appendicitis in Children with Abdominal Pain?

2019 ◽  
Author(s):  
Abuzer Coskun ◽  
Cengiz Güney
Keyword(s):  
Emergency Department ◽  
Regression Analysis ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Perforated Appendicitis ◽  
Multivariate Regression Analysis ◽  
Predictive Values ◽  
Fetuin A ◽  
Reactive Protein

Background: Acute appendicitis (AA) is the most common cause of emergency surgery. Perforation is more common than adults. Early diagnosis and new markers are needed. The aim of this study was to investigate the effects of plasma Fetuin-A (FA) levels in patients with the acute abdomen (AB). Material and Method: This prospective study included 107 patients younger than 16 years of age who were admitted to the emergency department for abdominal pain between January 2018 and December 2018. The patients who presented to abdominal pain were divided into two groups as AA and other causes (OC) of AB. T Patients with acute appendicitis; intraperitoneal, retrocolic / retrocecal and appendicitis were divided into three groups. Also, the AA group was divided into two groups as perforated appendicitis and non-perforated appendicitis. Serum FA levels of the patients were evaluated in the emergency department. Results: In the AA group, C-reactive protein (CRP) and white blood cell (WBC) levels were higher, and FA levels were significantly lower than in the AB group. Intraperitoneal localization was 95.2% and perforation was frequent. When significant values in the univariate regression analysis for acute abdomen and perforation were compared in the multivariate regression analysis, CRP, WBC, and FA levels were found to be prognostic. Also, decreased FA levels were associated with AA while too much decreased FA levels were associated with the risk of perforation. Conclusion: While trying to diagnose AA in children, the FA level, CRP and WBC may be predictive values to identify risk factors.

scholarly journals Can Fetuin-A, CRP, and WBC Levels Be Predictive Values in the Diagnosis of Acute Appendicitis in Children with Abdominal Pain?

Healthcare ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 110
Author(s):  
Cengiz Güney ◽  
Abuzer Coskun
Keyword(s):  
Emergency Department ◽  
Regression Analysis ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Perforated Appendicitis ◽  
Multivariate Regression Analysis ◽  
Predictive Values ◽  
Fetuin A ◽  
Reactive Protein

Background: Acute appendicitis (AA) is the most common cause of emergency surgery. Therefore, perforation is common. Early diagnosis and new markers are needed. The aim of this study was to investigate the effects of plasma Fetuin-A (FA) levels in patients with an acute abdomen (AB). Material and Method: This prospective study included 107 patients younger than 16 years of age who were admitted to the emergency department for abdominal pain between January and December 2018. The patients who presented abdominal pain were divided into two groups as AA and other causes (OC) of AB. Patients with acute appendicitis; intraperitoneal, retrocolic/retrocecal, and appendicitis were divided into three groups. Additionally, the AA group was divided into two groups as perforated appendicitis and non-perforated appendicitis. Serum FA levels of the patients were evaluated in the emergency department. Results: In the AA group, C-reactive protein (CRP) and white blood cell (WBC) levels were higher, and FA levels were significantly lower than in the AB group. Intraperitoneal localization was 95.2% and perforation was frequent. When significant values in the univariate regression analysis for acute abdomen and perforation were compared in the multivariate regression analysis, CRP, WBC, and FA levels were found to be prognostic. Furthermore, decreased FA levels were associated with AA, while too greatly decreased FA levels were associated with the risk of perforation. Conclusion: Current diagnosis can be made by history, physical examination, laboratory, and imaging methods in appendicitis cases. While trying to diagnose AA in children, the FA, CRP, and WBC levels may be predictive values to identify risk factors.

Appendicitis: a rare adverse event in colonoscopy

2021 ◽  
Vol 14 (7) ◽  
pp. e242523
Author(s):  
Samer Al-Dury ◽  
Mohammad Khalil ◽  
Riadh Sadik ◽  
Per Hedenström
Keyword(s):  
Emergency Department ◽  
Adverse Event ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Physical Examination ◽  
De Novo ◽  
Perforated Appendicitis ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.

scholarly journals Evaluation of using Alvarado score and C-reactive protein in diagnosing acute appendicitis in children

2010 ◽  
Vol 67 (8) ◽  
pp. 644-648
Author(s):  
Ana Kostic ◽  
Andjelka Slavkovic ◽  
Zoran Marjanovic ◽  
Jelica Madic ◽  
Marijana Krstic ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Scoring Systems ◽  
C Reactive Protein ◽  
Diagnostic Challenge ◽  
Alvarado Score ◽  
Predictive Values ◽  
Reactive Protein ◽  
Group I ◽  
Group Ii

Background/Aims. Acute appendicitis (AA) remains a diagnostic challenge in children, despite ongoing researches. With an aim to facilitate making diagnosis of AA many scoring systems have been created; among them Alvarado score is the most popular. C-reactive protein (CRP) has proven significance for diagnosing AA in adults, but not in children. The aim of this study was to evaluate significance of Alvarado score, as well as CRP values, in making diagnosis of AA in children. Methods. This prospective six-month study was performed on 257 patients under the age of 15, admitted for acute abdominal pain in the Clinic of Pediatric Surgery and Orthopedics in the Clinical Centre of Nis. Alvarado score and CRP values were determined on admission and compared with final diagnosis on discharge. The patients were divided into two groups: group I - non operated patients with abdominal pain (n = 184) and group II - operated on patients for appendectomy (n = 73). Results. Values of Alvardo score were statistically significantly different between groups (group I: 4.9 ? 1.21, group II: 8.55 ? 1.32). Also, our results showed significantly high values of CRP measured in operated children (group I: 8.17 ? 4.7 mg/L, group II: 38 ? 26 mg/L). Values of validity parameters for Alvarado score were: sensitivity 90%, specifity 80%, positive predictive values 87%; for CRP 95%, 70% and 80%, respectively. Conclusion. Alvarado score and CRP are very useful adjuvant diagnostic tool for AA to a less experienced surgeon. High values of Alvarado score and CRP cannot be ignored neither at the same time, used as the sole diagnostic method for discriminating children with AA.

scholarly journals The diagnostic value of white cell count, C-reactive protein and bilirubin in acute appendicitis and its complications

2013 ◽  
Vol 95 (3) ◽  
pp. 215-221 ◽  
Author(s):  
I G Panagiotopoulou ◽  
D Parashar ◽  
R Lin ◽  
S Antonowicz ◽  
AD Wells ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Cell Count ◽  
Inflammatory Markers ◽  
White Cell Count ◽  
Perforated Appendicitis ◽  
Diagnostic Value ◽  
White Cell ◽  
C Reactive Protein ◽  
Reactive Protein

Introduction Inflammatory markers such as white cell count (WCC) and C-reactive protein (CRP) and, more recently, bilirubin have been used as adjuncts in the diagnosis of appendicitis. The aim of this study was to determine the diagnostic accuracy of the above markers in acute and perforated appendicitis as well as their value in excluding the condition. Methods A retrospective analysis of 1,169 appendicectomies was performed. Patients were grouped according to histological examination of appendicectomy specimens (normal appendix = NA, acute appendicitis = AA, perforated appendicitis = PA) and preoperative laboratory test results were correlated. Receiver operating characteristic (ROC) curve area analysis (area under the curve [AUC]) was performed to examine diagnostic accuracy. Results ROC analysis of all laboratory variables showed that no independent variable was diagnostic for AA. Good diagnostic accuracy was seen for AA when all variables were combined (WCC/CRP/bilirubin combined AUC: 0.8173). In PA, the median CRP level was significantly higher than that of AA (158mg/l vs 30mg, p<0.0001). CRP also showed the highest sensitivity (100%) and negative predictive value (100%) for PA. CRP had the highest diagnostic accuracy in PA (AUC: 0.9322) and this was increased when it was combined with WCC (AUC: 0.9388). Bilirubin added no diagnostic value in PA. Normal levels of WCC, CRP and bilirubin could not rule out appendicitis. Conclusions CRP provides the highest diagnostic accuracy for PA. Bilirubin did not provide any discriminatory value for AA and its complications. Normal inflammatory markers cannot exclude appendicitis, which remains a clinical diagnosis.

scholarly journals Pediatric Appendicitis Score in differential diagnosis of acute nonspecific abdominal pain in children: age matters

2021 ◽  
pp. 22-31
Author(s):  
V.G. Vakulchyk ◽  
◽  
A.V. Kapytski ◽  
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Roc Curves ◽  
Diagnostic Value ◽  
Diagnostic Significance ◽  
Predictive Values ◽  
Detection Frequency ◽  
Specificity And Sensitivity ◽  
Appendicitis Score

Acute nonspecific abdominal pain in children is the most common problem requiring differential diagnosis with acute appendicitis. Scales for integrated assessment of individual symptoms and their combinations have been proposed and are constantly being developed that allow predicting the likelihood of acute appendicitis. Purpose to assess diagnostic value of Pediatric Appendicitis Score (PAS) in groups of children in different ages. Materials and methods. 374 children aged 4 to 15 years with acute abdominal pain were evaluated in prospective randomized blinded study. Statistical analysis: ROC – curves, specificity and sensitivity, positive and negative predictive values; Kullback criteria; logistic regression analysis; discriminant analysis. Results. Detection frequency and diagnostic significance of the PAS scale predictors as well as obtained results by using the Pediatric Appendicitis Score depend on children age significantly. In terms of diagnosis of acute appendicitis, the PAS scale shows the best results in older children. Conclusions. Results of Pediatric Appendicitis Score depend on children ages due to different diagnostic value of predictors used in the PAS scale. Pediatric surgeons should keep in your mind these data. Modification of the scale is required taking into account the patient’s age. Further analysis of the issue of PAS using is needed. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: acute appendicitis, children, diagnosis, PAS scale.

APPENDECTOMY IN CHILDREN WITH ACUTE RHEUMATIC FEVER

PEDIATRICS ◽  
1969 ◽  
Vol 43 (4) ◽  
pp. 573-577
Author(s):  
Jer-Shoung Lin ◽  
Ramon Rodriguez-Torres
Keyword(s):  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Laboratory Data ◽  
Initial Symptom ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The Right

Clinical and laboratory data on five patients with appendectomy, later proved to have acute rheumatic fever, are presented in detail. The findings indicate that abdominal pain simulating acute appendicitis can be presented as the only initial symptom in acute rheumatic fever. Awareness and knowledge of the presence of clues-high fever, rapid sedimentation rate, prolonged P-R interval, and 4 plus C-reactive protein-usually help to make the differential diagnosis. However, if doubt remains, the right approach is to go ahead with surgery since these patients tolerate anesthesia and laparotomy very well.

scholarly journals Influence of Myeloperoxidase Levels on Periodontal Disease: An Applied Clinical Study

2020 ◽  
Vol 10 (3) ◽  
pp. 1037
Author(s):  
Alessandro Polizzi ◽  
Salvatore Torrisi ◽  
Simona Santonocito ◽  
Mattia Di Stefano ◽  
Francesco Indelicato ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Regression Analysis ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Healthy Controls ◽  
Plasma Samples ◽  
C Reactive Protein ◽  
Periodontal Health ◽  
Reactive Protein ◽  
And Control

In this trial, we evaluated the influence on plasma and salivary myeloperoxidase (MPO) levels of periodontal health, coronary heart disease (CHD), periodontitis, or both periodontitis and CHD. Clinical and periodontal parameters were collected from periodontitis patients (n = 31), CHD patients (n = 31), patients with both periodontitis and CHD (n = 31), and from healthy patients (n = 31) together with saliva and plasma samples. The median concentrations of salivary and plasma MPO were statistically higher in the CHD patients [plasma: 26.2 (18.2–34.4) ng/mg; saliva 83.2 (77.4–101.5) ng/mL, p < 0.01] and in the periodontitis plus CHD patients [plasma: 27.8 (22.5–35.7) ng/mg; saliva 85.6 (76.5–106.7) ng/mL, p < 0.001] with respect to periodontitis and control patients. Through a univariate regression analysis, c-reactive protein (CRP) and CHD (both p < 0.001) and periodontitis (p = 0.024) were statistically correlated with MPO in plasma. The multivariate regression analysis demonstrated that only CRP was statistically the predictor of MPO in plasma (p < 0.001). The multivariate regression analysis in saliva demonstrated that, regarding MPO levels the only predictors were CRP (p < 0.001) and total cholesterol (p = 0.035). The present study evidenced that subjects with CHD and periodontitis plus CHD had higher plasma and salivary levels of MPO compared to subjects with periodontitis and healthy controls.

The Use of Thiol/Disulfide Homeostasis Parameters in the Diagnosis of Acute Appendicitis in Children

2020 ◽  
Vol 15 (04) ◽  
pp. 195-199
Author(s):  
Cüneyt Uğur ◽  
Hasan Madenci ◽  
Hüseyin Kurku ◽  
Salim Neşelioğlu
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Pain Group ◽  
Reactive Protein ◽  
Total Thiol ◽  
Stress Markers ◽  
Significant Difference ◽  
Antioxidant Parameters ◽  
New Biomarkers ◽  
Thiol Level

Abstract Objective The aim of this study was to determine the role of thiol/disulfide homeostasis (TDH) parameters which are new oxidative stress markers for the diagnosis of acute appendicitis (AA) in children with abdominal pain complaints. Methods A total of 40 patients with AA and 45 patients with abdominal pain were included in this study. Two groups were compared in terms of age, gender, white blood cell count, neutrophil-to-lymphocyte ratio, C-reactive protein (CRP), appendix diameter, and TDH parameters (native and total thiol levels, native thiol/total thiol ratio [antioxidant parameters] and disulfide level, disulfide/native thiol ratio, and disulfide/total thiol ratio [oxidant parameters]). Results Compared with the abdominal pain group, it was found that disulfide level, disulfide/native thiol, and disulfide/total thiol ratios (p < 0.001 for all) in patients with AA were significantly higher and their native thiol level (p = 0.02) and native thiol/total thiol ratio (p < 0.001) were significantly lower. There was no significant difference between the two groups in terms of total thiol level. There was no significant difference between the perforated and nonperforated groups in patients with AA in terms of TDH parameters. In addition, the CRP level was higher in the perforated group than the nonperforated group. Conclusion To our knowledge, the present study is a first in the literature in which TDH parameters were used in children with AA compared with the abdominal pain group. We thought that these parameters may be useful as new biomarkers supporting AA diagnosis in children.

scholarly journals The value of pancreatic stone protein in predicting acute appendicitis in patients presenting at the emergency department with abdominal pain

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Christoph Tschuor ◽  
Dimitri Aristotle Raptis ◽  
Përparim Limani ◽  
Thomas Bächler ◽  
Christian Eugen Oberkofler ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Pancreatic Stone Protein ◽  
Pancreatic Stone

scholarly journals Role Of C-Reactive Protein in Diagnosis of Acute Appendicitis

2021 ◽  
Vol 10 (4) ◽  
pp. 210-214
Author(s):  
Mirza Tassawar Hussain ◽  
Muhammad Kashif Khan ◽  
Syed Shamsuddin ◽  
Aabid Ali ◽  
Erum Khan ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
C Reactive Protein ◽  
Diagnostic Dilemma ◽  
Senior Registrar ◽  
Predictive Values ◽  
Reactive Protein ◽  
Highly Sensitive ◽  
Sensitivity Specificity

Background: Appendicitis is a common surgical emergency and diagnostic dilemma. Making the correct diagnosis is often difficult as the clinical presentation varies according to the age of the patient and the position of appendix. The objective of this study was to identify clinical applicability of C- reactive protein, as a diagnostic test for appendicitis. Methods: This prospective study was carried out in Federal government Polyclinic hospital, Islamabad from January to July 2019, 114 patients underwent appendectomy for clinically diagnosed acute appendicitis. The decision to operate the patient was given by senior registrar. The blood samples for C-reactive protein were drawn before taking the patient to the operating theatre. Removed appendices were sent for histopathological confirmation of diagnosis. The C-reactive protein was then compared with the results of histopathology to determine its validity. The data was entered and analysed in SPSS 23. Results: The sensitivity, specificity, positive and negative predictive values of C-reactive protein in patients with clinical diagnosis of acute appendicitis were found to be 94%, 78%, 93% and 74 % respectively. Conclusion: CRP is helpful in making diagnosis of acute appendicitis. It is highly sensitive but has a relatively low specificity.  

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