RGUHS Nat. J. Pub. Heal. Sci Vol: 14 Issue: 2 eISSN: pISSN
Kappikeri VS*, Akshay Mahesh Kriplani**
Professor, Department of Surgery, Post-Graduate, Department of Surgery, M.R. Medical College, Kalaburagi
Abstract
Acute appendicitis is the most common cause of acute abdomen in children and adults. The incidence of complicated acute appendicitis remains considerably high (28-29%) despite availability of modern imaging. The aim was to study the contribution of Total leucocyte count (TLC) and Appendicular size on ultrasonography (USG) as predictors of perforation in cases of acute appendicitis. 50 patients with a diagnosis of acute appendicitis were included in the study. TLC and USG were done for all patients. 47 patients underwent appendicectomy and 3 patients with mass formation were managed conservatively. Perforated appendix was found in 26% of the cases. 23 (46%) cases had a TLC >10,000/cumm. 12 of these cases landed up in appendicular perforation. 38.46% cases with appendicular perforation had a neutrophil count >80,30.76% had count>70 and 15.38% cases had count >90, suggesting that neutrophils are a better indicator of perforation. Of 13 cases with appendicular perforation, 12 cases (92.3%) had an appendicular size >10 mm. 7 (58.33%) out of 12 patients with appendicular size 10 mm on USG also showed features of perforation which was confirmed intra-operatively. In patients with a clinical diagnosis of acute appendicitis with an appendicular size >10 mm and TLC > 11,000/cumm should be identified as having higher probability of appendicular perforation. Therefore patients with appendicular size 9 mm and above should be considered for emergency intervention.
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