Diagnostic Performance of C Reactive Protein and Delta CRP in Acute Appendicitis
Diagnostic Performance of C Reactive Protein and Delta CRP in Acute Appendicitis
The diagnosis of acute appendicitis is difficult and despite important advances in medical
 sciences, detailed patient questioning and precise medical examination are the main keystones
 of the diagnosis of acute appendicitis and up to now, results still unsatisfactory.
Acute appendicitis is the most common surgical emergency and the most common source of
 community-acquired intra-abdominal infections. The lack of accuracy in the diagnosis of acute
 appendicitis yields often to two types of outcomes: a delay in diagnosis leads to perforation
 and peritonitis in up to 15% of the cases and unnecessary appendectomy is associated with
 post-operative complications such as wound infection and adhesions. CRP is an acute phase
 protein that is often used by many surgeons as a diagnostic marker of acute appendicitis.
 During the evaluation of patients with possible appendicitis in the emergency department
 (ED), repeated physical examination of the abdomen may provide further information about the
 decision making. However, the role of repeated laboratory examinations is not proven.

 The purpose of this study was to investigate whether repeated serum CRP measures could be
 useful to predict acute appendicitis, after 3 hours of observation, in comparison with the
 histopathological findings.
Inclusion Criteria:

 -  age > 8 year old

 -  clinical suspicion of acute appendicitis including the presence of direct tenderness
 in the right lower quadrant, percussion and rebound tenderness, pyrexia, anorexia,
 nausea and vomiting.

 Exclusion Criteria:

 -  patients receiving anti coagulants

 -  pregnant women

 -  patients using antibiotics during the study period.