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Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi
2006, Cilt 20, Sayı 6, Sayfa(lar) 403-408
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The Diagnostic Value of High-Sensitivity C-Reactive Protein and 5-HydroxyIndole Acetic Acid in Patients With Suspected Acute Appendicitis
Mustafa YILDIZ1, Alaattin GEDİKLİ1, M. Nuri BOZDEMİR1, Dilara SEÇKİN2, Mustafa BAŞTÜRK1, Mehtap GÜRGER1, Mehmet ÖZDEN3, Nurullah BÜLBÜLLER4
1Fırat Üniversitesi Tıp Fakültesi Acil Tıp Anabilim Dalı Elazığ-TÜRKİYE
2Fırat Üniversitesi Tıp Fakültesi Biyokimya Anabilim Dalı Elazığ-TÜRKİYE
3Fırat Üniversitesi Tıp Fakültesi İmmünoloji Anabilim Dalı Elazığ-TÜRKİYE
4Fırat Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalı Elazığ-TÜRKİYE
Keywords: Acute appendisitis, emergency department, 5-HIAA, hsCRP, diagnosis

Acute appendisitis is the most common reason of acute abdomen syndrome. It is a disease effecting approximately 6% of the population. Problems may occur in the diagnosis of appendisitis because of the different localizations and absence of certainty in clinial and laboratory findings. History and physical examination are important features for the diagnosis. The aim of our study was to find the value 5-hydroxy indol acetic acid (5-HIAA) and of serum sensitive C-reactive protein in the distinctive diagnosis of acute appendisitis in the emercency service.

The study was performed on 37 patints who were thought to have acute appentisitis and aged 16 and over, in FÜTF Hospital between January-October 2005. FM findings, laboratory results, hsCRP and 5-HIAA levels, treatment methods, diagnosis and results were recorded to the forms. Blood samples for the leucocyte count and hsCRP and spot urine for 5-HIAA were taken from all patients. The most common complaints were nausea and vomiting (56,7%), and the most common examination finding was inferior abdominal sensitivity (42%). Patients with appendisitis diagnosis and suspicious for appendisitis had average hsCRP values of 8,49±2,98 mg/dl, 7,69±3,7 mg/dl, 5- HIAA values of 7,81±1,38 mg/L, 8,21±1,23 mg/L, and leucocyte values of 14766±3885 x 10³/µL, 13774±4693 x 10³/µL respectively. There was no statistically significant difference between groups (p>0,05) 23 of 37 patients (%62,2) having a first diagnosis of acute appendisitis were poerated surgically and the diagnosis was confirmed pathologically for 21 (%56,7). Negative appendectomia was determined for 4 patients.

As a result, it is considered that the priority of diagnosing appendisitis may be up to the experience and knowledge of the physician, that the biochemical and radiologic findings may support the diagnosis, that hsCRP may be a helper determinant in the diagnosis of acute appendisitis but its low spesifity may decrease the value of diagnosis. We also think that the measurement of 5-HIAA in spot urine is not useful in the diagnosis of acute appendisitis.

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