A CROSS-SECTIONAL STUDY ON COMPARISON OF OUTER DIAMETER OF APPENDIX ON ULTRASONOGRAPHY, C-REACTIVE PROTEIN AND SERUM BILIRUBIN LEVELS IN COMPLICATED VERSUS UNCOMPLICATED APPENDICITIS.

Background: It is estimated that accuracy of clinical diagnosis of acute appendicitis is only between 76 percent and 92 percent. Parameters like outer diameter of appendix on ultrasonography, and biochemical parameters like raised CRP and hyperbilirubinemia helps to improve the accuracy of pre- operative diagnosis of acute appendicitis. Our objective is to compare the outer diameter of the inflamed appendix on ultrasonography, values of CRP and total serum bilirubin in complicated versus uncomplicated appendicitis. Methods: In our study 60 patients diagnosed to have acute appendicitis clinically were subjected to Ultrasonography, CRP and Total Serum Bilirubin. Chi-square test and unpaired 't' test were used to compare categorical and continuous variables respectively. Receiver operating characteristics (ROC) curve was used for different cut off points of appendicular diameter, CRP and total serum bilirubin. Results: In our study, maximum number of patients were in the 21 to 40 years age group accounting for 58.34% of total cases. The mean total serum bilirubin in cases of uncomplicated appendicitis was 0.85 ± 0.39 mg/dl and in complicated appendicitis, it was 1.98 ± 0.55 mg/dl. The mean CRP in cases of uncomplicated appendicitis was 2.50 ± 1.86 mg/dl and in complicated appendicitis, it was 15.07 ± 7.28 mg/dl. The mean appendicular diameter in uncomplicated appendicitis was 8.65±1.98 mm and in complicated appendicitis it was 10.07 ± 1.42 mm. Pre-operative total serum bilirubin and CRP values have higher sensitivity (95.24%) and specificity (84.61%) than appendicular diameter on USG in diagnosing complicated appendicitis. Conclusion: Use of biochemical parameters such as total serum bilirubin and CRP, radiological such as outer diameter of appendix on USG helps in diagnosing complicated appendicitis preoperatively [ABSTRACT FROM AUTHOR]