Value of biochemical markers in the diagnosis and prediction of severity of acute appendicitis in children: a prospective randomized study

Abstract

Background Appendectomy is one of the most commonly performed operations. Clinical evaluation of patients with acute appendicitis was the cardinal key point of diagnosis. Aim To evaluate the value of serum inflammatory markers in the diagnosis of acute appendicitis and suspicion of complication. Patients and methods This study was applied on children from 1 to 16 years old, who were diagnosed clinically as having acute appendicitis. Blood samples were collected from all patients for interleukin 6 (IL-6), C-reactive protein (CRP), white blood cells (WBC), and procalcitonin levels. Appendectomy was done for all patients, followed by histopathological examination for all specimens. The patients operated were classified according to the histopathological results. Results Over a span of the 12 months, 64 patients between 1 and 16 years old were operated for appendectomy and the positivity was confirmed by histopathology results. The positive group included 57 (89.1%) patients, while seven (10.9%) patients were included in the negative group. The 57 positive cases were subdivided into two groups: 33 (57.9%) cases had complicated appendicitis, while the other 24 (42.1%) cases had simple appendicitis. The values of biochemical markers: CRP, IL-6, procalcitonin, and WBCs, for all patients were assessed comparing the groups together. It was found that these markers were very significant in the differentiation of different groups. Conclusion Routine use of biochemical markers WBC, CRP, IL-6, and procalcitonin in children with suspected appendicitis is very helpful to increase the accuracy of diagnosis and to predict complication.