Main findings in laboratory tests diagnosis of acute appendicitis: a prospective evaluation.

BACKGROUND Acute appendicitis is the most common surgical abdominal disease in the emergency room. Although the diagnosis is clinical the complementary tests may be useful in doubt. AIM To evaluate the main laboratory tests in patients with acute appendicitis, as well as its relationship with the evolutionary stage of the disease. METHODS Prospective evaluation of patients with acute appendicitis who underwent surgical treatment. RESULTS A total of 179 patients participated in this study, most were male. The mean age was 26 years. For leukocyte count 46.9% had values ​​<15.000mm3. The mean percentage of polymorphonuclear cells was 81,7%, 1,2% of sticks, 1% eosinophils, lymphocytes 12,8% and 2,9% monocytes. C-reactive protein was required for 54 patients. It was <10 mg/dl in 19, between 10 and 50 mg/dl in 24 and greater than or equal to 50 mg/dl in 11. Regarding the evolutionary phase 64% patients had early stage (stages 1 and 2), 16,2% stage 3 and 35 stage 4. A total of 57% of patients with white blood cell count greater than or equal to 20.000/mm3 had appendicular perforation (p<0,05). The percentage of polymorphonuclear leukocytes from patients with early stages was lower than the later stages (79,8% and 85,1%, respectively), with p<0,05. Patients with advanced stages of acute appendicitis, the number of lymphocytes was lower than the initial stages (9,3% and 14,8%, respectively), with p<0,05. 94% of patients with C-reactive protein values ​​<10 mg/dl showed early stages of appendicular inflammation (p<0,05). CONCLUSION A significant association among total and differential leukocyte count, C-reactive protein values ​​and evolutionary phase of appendiceal inflammation was found in this prospective analysis.