Document Detail

White cell count and C-reactive protein measurement in patients with possible appendicitis.
MedLine Citation:
PMID:  19102827     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Clinical assessment outweighs the use of investigations in the diagnosis of acute appendicitis. Nevertheless, white cell count (WCC) and C-reactive protein (CRP) are regularly measured in patients with suspected appendicitis. The aim of this study was to assess the utility of these markers in patients presenting with acute lower abdominal pain.
PATIENTS AND METHODS: WCC and CRP were measured prospectively in 98 patients presenting with lower abdominal pain, and the results were correlated with each patient's outcome.
RESULTS: No patients with WCC and CRP both in the normal range had acute appendicitis. Raised WCC and CRP were poor positive predictors of appendicitis, both alone and in combination, and correlated poorly with the development of complications.
CONCLUSIONS: This result may have important clinical and economic implications. We suggest that patients experiencing lower abdominal pain, with normal WCC and CRP values, are unlikely to have acute appendicitis and can be safely sent home.
Anshuman Sengupta; George Bax; Simon Paterson-Brown
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Publication Detail:
Type:  Journal Article     Date:  2008-12-19
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  91     ISSN:  1478-7083     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-25     Completed Date:  2009-07-07     Revised Date:  2011-12-01    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  England    
Other Details:
Languages:  eng     Pagination:  113-5     Citation Subset:  IM    
Department of General Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
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MeSH Terms
Acute Disease
Appendicitis / diagnosis*
C-Reactive Protein / metabolism*
Leukocyte Count / methods*
Prospective Studies
Reg. No./Substance:
9007-41-4/C-Reactive Protein
Comment In:
Ann R Coll Surg Engl. 2011 Mar;93(2):183   [PMID:  22041163 ]
Ann R Coll Surg Engl. 2009 Sep;91(6):538; author reply 538-9   [PMID:  19723423 ]

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