Role of serum C-reactive protein and leukocyte count in the diagnosis of acute appendicitis in Nepalese population.

Various diagnostic modalities have been reported to influence the negative appendicectomy. C-reactive protein (CRP), an acute phase reactant, may improve the accuracy of diagnosing acute appendicitis. The present study was undertaken to evaluate the utility of CRP as a diagnostic tool among patients clinically suspected to have acute appendicitis. The role of total leukocyte (WBC) count was also studied. A total of 145 diagnosed cases of acute appendicitis were studied over a period of one and half years. CRP was raised in 91 cases and was normal in 54 cases. The sensitivity and specificity of CRP estimation in diagnosing appendicitis was 74.8% and 66.7% respectively and the sensitivity and specificity for total WBC count was 78.6 and 54.8% respectively. The present study suggests that we cannot rely wholly on CRP or on WBC count for operative decision. Clinical judgment is still the best modality for the diagnosis and operative management of acute appendicitis. It seems wiser to use active observation, which should identify most patients with non-specific pain and reserve operation for those who need it most.