AA is the most common indication for emergency abdominal surgery worldwide, with a lifetime incidence of 7% [10]. It can occur at any age, with peak incidence in the mid-20s. AA is one of the most common surgical emergencies, but its exact cause is still unknown [11], And accurate diagnostic tools have not yet been established. Previous traditional methods for diagnosing AA, such as medical history, physical examination, and laboratory tests, required providing sufficient and accurate data to confirm the diagnosis of AA at an early stage. Although radiological tests such as computed tomography and ultrasound are promising for early diagnosis, sufficient accuracy is still required for the diagnosis of AA. [12].
Our study included 106 patients who showed features of AA, with the majority presenting with right iliac fossa pain (98.2%, n = 108), and 88 (80%) with They showed rebound tenderness and 94 (85.5%) had nausea. Loss of appetite, vomiting. Although 106 patients underwent emergency appendectomy, histopathological evidence of an inflamed appendix was found in only 87 (82%), making it more accurate to diagnose AA as previously described. The need for such tools is emphasized.
MPV in acute appendicitis
Several studies have investigated the diagnostic value of laboratory inflammatory markers such as MPV in the diagnosis of AA, and a reduction in MPV has been observed in this case. [11, 13, 14]. Similar to these studies, we found significant results (p value = < 0.001), 87 (82%) of patients had a lower MPV (< 7.5 fL) in inflammatory appendicitis compared with non-inflammatory appendicitis, especially during the first 24 hours of onset. The significance in his MPV between inflamed and healthy patients continued after 24 hours (p value = 0.002).
Contrary to these findings, Uyanik [15] No significant decrease in MPV was observed in AA patients. In contrast, Narci et al. [16] and Aktimuret et al. MPV was reported to be significantly higher in AA patients [17]. The sensitivity and specificity of MPV in diagnosing AA were 84.6% and 90%, respectively, in the first 24 hours, and the sensitivity decreased and specificity increased to 100% in the next 24 hours (60%).a study [18] Sixty-three percent of patients indicated seeking medical attention for AA 2 days after symptom onset.others [19] The average duration of symptoms before seeking medical attention was found to be 3.7 and 4 ± 3.5 days, respectively. These findings indicate that a normal MPV count can accurately exclude the presence of AA.
TWBC in acute appendicitis
Previous studies have also shown interest in comparing TWBC counts between AA patients and healthy individuals. Egemen Kucuk et al. [14] White blood cell count was found to be 14.3 ± 2.99 × 10 .3/hmm3, which is significantly higher than in healthy individuals, with sensitivity and specificity of 94% and 75%, respectively. In the current study, the number of TWBC also appears to be significantly increased (p In AA patients, value = < 0.001), mean 12.3 ± 3.6 × 103/mm3. Unlike previous studies, leukocyte sensitivity was low and specificity was high (67.8% and 94.7%) in diagnosing AA. Previous studies have also reported low sensitivity and high specificity for leukocytes, and the sensitivity and specificity were found to be 67–97.8%, respectively. [17]. TWBC was reported to be the first laboratory value to indicate inflammation of the appendix, and several previous studies also [18, 19] We showed that most of the AA patients presented with leukocytosis.
Research limitations
Although this study adds useful results regarding the number of MPVs in AA, it also has some limitations. The sample of patients included in this study was relatively small, which was considered a limitation of the study. This study may have limitations due to the accuracy of diagnostic methods such as computed tomography, ultrasound, histopathology, and physical examination. This study did not examine all age groups.