LÖKOSİT SAYISI VE C-REAKTİF PROTEİNİN AKUT APANDİSİT TANISINA KATKISI: BİR İLÇE HASTANESİ DENEYİMİ

Buyuk merkezlere yakin olmayan bir ilce hastanesinde lokosit sayisi ve C-reaktif protein duzeyindeki artisin akut apandisit olgularinin tanisinda ne kadar yardimci oldugunu saptamak.Ocak 2011 ile Haziran 2012 tarihleri arasinda apendektomi uygulanmis hastalar retrospektif olarak incelendi. Baska nedenle opere edildigi halde apendektomi uygulanmis hastalar calismaya dahil edilmedi. Hastalar histopatolojik degerlendirme sonuclarina gore apandisit ve negatif apendektomi olmak uzere iki gruba ayrildi. 5 hastaya laparoskopik, 65 hastaya acik apendektomi uygulandi. Negatif apendektomi oranimiz %14.3 olarak belirlendi. Apandisit ve negatif apendektomi gruplari arasinda hem ortalama lokosit sayisi (p<0.01) hem de C-reaktif protein duzeyi (p=0.02) acisindan anlamli farklilik izlendi. Ancak lokosit sayisi ve C-reaktif protein duzeyinin birlikte arttiginda ozgullugun en yuksek oldugu (%90) saptandi. 6 hastamizda postop morbidite izlenirken, ortalama yatis suresi 2.3 gundu.Lokosit sayisi ve Creaktif protein duzeyi pek cok merkezde rahatlikla bakilabilmektedir, ancak klinik bulgularla birlestirilerek yorumlandiklarinda akut apandisit tanisina katkida bulunabilirler. Sag alt kadran agrisi ile acil servise basvuran bir hastada bu tetkikler normal duzeylerde ise akut apandisit olasiligi oldukca dusuktur, bu hastalarda acil apendektomi karari vermeden once belirli araliklarla yeniden degerlendirerek gozlem altinda tutmanin imkanlari sinirli merkezlerde dahi negatif apendektomi oranlarini azaltacagini dusunuyoruz. Anahtar Kelimeler: Akut apandisit, lokosit, c-reaktif protein. Abstract To determine if white blood cell count and C-reactive protein contribute the diagnosis of acute appendicitis in a town hospital that is far away high-volume centers.Patients who underwent appendectomy between January 2011 and June 2012 reviewed retrospectively. Patients who were performed appendectomy as a secondary of another operation excluded from the study. Patients distributed into two groups: appendicitis and negative appendectomy.65 patients were performed open appendectomy while other 5 patients underwent laparoscopic appendectomy. Negative appendectomy rate was 14.3%. Both mean white blood cell counts (p<0.01) and Creactive protein levels (p=0.02) were significantly different for two groups. However, the highest specificity (90%) was obtained when both of them raised. 6 patients had morbidities in the postoperative course, and the mean length of hospital stay was 2.3 days.White blood cell count and C-reactive protein level are simple tests that can be worked in many centers; however, they can only facilitate acute appendicitis diagnosis when they interpreted with clinical findings. Possibility of acute appendicitis is very low, in a patient who admits emergency department with low right abdominal pain, when both tests are in normal ranges. We believe that observation with reevaluation in certain intervals would contribute on reducing negative appendectomy rate even in centers with limited facilities. Key words: Acute appendicitis, white blood cell, c-reactive protein.