Role of Total Leukocyte Count in Different Stages of Acute Appendicitis and Frequency of Negative Appendectomy in Tertiary Care Hospital

Abstract

Objective: To study the role of total leukocyte count (TLC) in different stages of acute appendicitis. To find out the frequency of negative appendectomy in a tertiary care hospital.
Study design: This was a cross-sectional study.
Place and duration of the study: The study was conducted in Surgical Unit 1 of Jinnah Postgraduate Medical Center, Karachi, Pakistan, from December 2019 to December 2020.
Methodology: One hundred twelve participants were included, above 12 years of acute appendicitis. Clinical findings and TLC recorded on Performa. Appendectomy was performed, and operative results were recorded. Specimens of the appendix were sent for histopathological evaluation recorded as usual, catarrhal, suppurative, and gangrenous.
Results: Out of 112 patients, 82 (73%) were male, and 30 (27%) were female. Ten (9%) patients were 13–20 years old, 62(55%) were
21–30 years old, 30 (27%) were 31–40 years old, 8 (7%) were 41–50 years old, and 2 (1.79%) were older than 50 years. TLC was elevated in 108 patients (96%): more than 13,000 in 56 (50%) patients. On histopathology, catarrhal appendicitis in 60 (54%), suppurative appendicitis in 30 (27%), gangrenous appendicitis in 18 (16.07%), and negative appendectomy in 4 (3.6%). TLC was more than 13,000 in gangrenous appendicitis in 16 (88.88%) out of 18 patients, in suppurative appendicitis in 28 (93%) out of 30, and in catarrhal appendicitis in 12 (20%) out of 60.
Conclusion:  Raised TLC has diagnostic significance and is helpful in the diagnosis of appendectomy to prevent complications of
appendicitis, and TLC greater than 13,000 shows complicated appendicitis.
Keywords: Acute appendicitis, total leukocyte count, gangrenous appendicitis.