The role of complete blood count parameters in distinguishing complicated and uncomplicated appendicitis

Introduction Acute appendicitis (AA) is a prevalent disease that can be lifethreating if left untreated. There have been advances in imaging techniques recently, which facilitated the hand of physicians, but they are not widely available and require expertise to interpret. This makes diagnosis of appendicitis challenging for physicians working in rural regions. Complete blood count (CBC) is still the first line of test for a patient with abdominal pain in emergency departments (1). It is an easy and quick test to evaluate hematologic parameters which can be changed due to infection, hemorrhage and genetic disorders. Systemic inflammatory response is generally associated with white blood cell (WBC) count (2). However, WBC has no role in differentiating simple and complicated appendiceal disease. In addition to WBC count, there are several other markers that can be used as a sign of inflammatory conditions. For instance, neutrophil-to-lymphocyte ratio (NLR) is an indicator of subclinical inflammation (3). Also, red blood cell distribution width (RDW) has been reported to be in relation to infection (4). Furthermore, platelets play a crucial role in inflammation and their size can change as a result of inflammatory conditions. Therefore, mean platelet volume (MPV), which is a measurement of the average size of platelet in the blood, may have diagnostic potential in various diseases (5,6).