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    Evaluation of Diagnostic Value of Imaging and Laboratory Tests in Patients Who Underwent Laparotomy with The Diagnosis of Acute Appendicitis
    (2020) Ünal, Ramazan; Atik, Dilek; Güven, Ramazan; Çam, Hasan; Din, Mustafa Sait; Cander, Başar
    Abstract: Objective: Acute appendicitis (AA) is an inflammation of the appendix vermicularis tissue. In this study, we planned to investigate the efficacy of imaging, laboratory tests of patients who were followed up with the pre-diagnosis of AA and underwent laparotomy. Method: In this study the files of patients who were operated on between 01.01.2018, and 12.30.2018 with the preliminary diagnosis of acute appendicitis in the Department of Emergency Medicine, Istanbul Kanuni Sultan Süleyman Education and Research Hospital of Istanbul Health Sciences University, were retrospectively reviewed. Abdominal computed tomography (ACT) revealed thickening of the appendiceal wall, increased streaking in the pericheal region, the presence of appendicolitis, and free fluid in the pericheal region were evaluated in favour of AA. The presence of non-compressible, blind-terminated tubular structure> 6 mm in diameter, target-sign on transverse examination, or presence of intraluminal hyperechoic appendicolith were considered as positive findings. Results: Considering the correlation between AA and blood parameters, there was a statistically weak negative correlation between neutrophilia and leukocytosis. There was no statistically positive or negative correlation with CRP as acute phase reactant. We believe that leukocyte count, other inflammatory markers, USG, CT, especially along with clinical findings, should be the tests to aid the surgeon in the diagnosis. When deciding on a laparotomy in AA, the surgeon should see and interpret all examination results, evaluate the patient with clinical findings, and add his/her experience and foresight. Conclusion: High diagnostic sensitivity of non-contrast CT compared to other imaging techniques comes to the fore as an auxiliary diagnostic tool in making diagnosis. It can be considered as the first choice instead of contrast- enhanced CT in patients who are thought to have AA in order to reduce the side effects of contrast media