Which one in the diagnosis of acute appendicitis: Physical examination, laboratory or imaging? A retrospective analysis in the light of pathological results

Abstract

Background:Acute appendicitis is the most frequently performed emergent operation. Although the clinical signs, symptoms and physical examination are the mainstay of diagnosis, imaging and biochemical tests also help. We analyzed the reliability of our operation decision and the contribution of biochemical tests and imaging to diagnosis in the light of pathological results.Material and Methods:The files of 361 patients (199male and 162 female) who underwent appendectomy were analyzed retrospectively in terms of age, sex, physical examination, blood tests, imaging and pathological results.Results:The mean age of the patients was found 31±13.5. Pathology revealed normal appendix in 20.1% of the cases. The patients with a leukocytosis or more were found an increased possibility of acute appendicitis. Physical examination was still the mainstay in diagnosis and ultrasound had a low sensitivity.Conclusion:Physical examination is still mainstay in acute appendicitis diagnosis. Leukocytosis of 11x103/ml or more increases the possibility of acute appendicitis.