THE VALUE OF INFLAMMATORY MARKERS FOR DIAGNOSIS AND INDICATION OF SEVERITY OF ACUTE APPENDICITIS
Autor(a) principal: | |
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Data de Publicação: | 2020 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.34635/rpc.717 |
Resumo: | Introduction: The purpose of this work was to recognise the value of clinical manifestations and laboratory tests to establish the diagnosis of acute appendicitis and the severity of histopathology findings. Materials and methods: This study evaluated 272 patients surgically treated for acute appendicitis, mean age 40 years old, between 2012 and 2013. Clinical and laboratory parameters were collected and then correlated with results of histopathology. Results: Histopathology confirmed the diagnosis of acute appendicitis in 238 (87.5%) cases: phlegmonous in 32, suppurative in 164, gangrenous/perforated in 42. No statistical difference was found in clinical manifestations between the group with confirmed acute appendicitis and the group with normal appendix. The leucocyte count was significantly superior in the group with confirmed acute appendicitis, however was not statistically different between the histological types. Leucocyte count of 10850x106/L showed discriminative power between normal appendix and inflamed appendix with a sensitivity, specificity and positive predictive value of 84.6%, 76,1% and 98.9% respectively. The C-Reactive protein was related to the severity of the inflammation, and a value of 5,27mg/dl was correlated with gangrenous/perforated appendicitis. Discussion/Conclusions: Leucocyte count superior than 10850x106/L can support the diagnosis of acute appendicitis when clinical suspicion exists. C-Reactive protein is related to the severity of inflammation. |
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THE VALUE OF INFLAMMATORY MARKERS FOR DIAGNOSIS AND INDICATION OF SEVERITY OF ACUTE APPENDICITISO VALOR DOS MARCADORES INFLAMATÓRIOS PARA O DIAGNÓSTICO E INDICAÇÃO DO GRAU DE SEVERIDADE DE APENDICITE AGUDAIntroduction: The purpose of this work was to recognise the value of clinical manifestations and laboratory tests to establish the diagnosis of acute appendicitis and the severity of histopathology findings. Materials and methods: This study evaluated 272 patients surgically treated for acute appendicitis, mean age 40 years old, between 2012 and 2013. Clinical and laboratory parameters were collected and then correlated with results of histopathology. Results: Histopathology confirmed the diagnosis of acute appendicitis in 238 (87.5%) cases: phlegmonous in 32, suppurative in 164, gangrenous/perforated in 42. No statistical difference was found in clinical manifestations between the group with confirmed acute appendicitis and the group with normal appendix. The leucocyte count was significantly superior in the group with confirmed acute appendicitis, however was not statistically different between the histological types. Leucocyte count of 10850x106/L showed discriminative power between normal appendix and inflamed appendix with a sensitivity, specificity and positive predictive value of 84.6%, 76,1% and 98.9% respectively. The C-Reactive protein was related to the severity of the inflammation, and a value of 5,27mg/dl was correlated with gangrenous/perforated appendicitis. Discussion/Conclusions: Leucocyte count superior than 10850x106/L can support the diagnosis of acute appendicitis when clinical suspicion exists. C-Reactive protein is related to the severity of inflammation. Introdução: O trabalho teve como objetivo conhecer o valor das manifestações clínicas e dos exames laboratoriais para o diagnóstico de apendicite aguda, e como sinalizadores do grau de severidade revelado posteriormente pelo exame anatomopatológico. Material e métodos: Em 272 doentes com idade média de 40 anos, operados por suspeita de apendicite aguda em 2012 e 2013 avaliaram-se parâmetros clínicos e laboratoriais e correlacionaram-se com o exame anátomo-patológico. Resultados: O exame anátomo-patológico confirmou o diagnóstico em 238 (87.5%) doentes e revelou apendicite aguda: flegmonosa em 32, supurada em 164, gangrenada/perfurada em 42. Não houve diferença significativa na gravidade ou no tipo de manifestações clínicas entre o grupo com apêndice patológico e o com histologia normal. O valor de leucocitose foi superior nos doentes com confirmação histológica de apendicite aguda, mas sem diferença entre os diferentes tipos histológicos. O valor de leucocitose de 10850x106/L mostrou sensibilidade (84.6%), especificidade (76,1%) e valor preditivo positivo (98.9%) na discriminação entre histologia normal e patológica. A PCR mostrou poder discriminativo entre os tipos histológicos, tendo o valor de PCR 5,27mg/dl significado estatístico para diagnóstico de apendicite aguda gangrenada/perfurada. Discussão/Conclusões: Quando existe suspeita clínica de apendicite aguda, a leucocitose superior a 10850x106/L pode ser um contributo válido para ajudar ao diagnóstico. A PCR é um bom indicador da severidade da inflamação revelada no exame histológico. Sociedade Portuguesa de Cirurgia2020-09-30info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34635/rpc.717https://doi.org/10.34635/rpc.717Revista Portuguesa de Cirurgia; No 48 (2020): Number 48 - September 2020; 25-32Revista Portuguesa de Cirurgia; No 48 (2020): Number 48 - September 2020; 25-322183-11651646-6918reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spcir.com/index.php/spcir/article/view/717https://revista.spcir.com/index.php/spcir/article/view/717/560Copyright (c) 2020 Revista Portuguesa de Cirurgiainfo:eu-repo/semantics/openAccessMelo, CatarinaMelo, FernandoFraga, EmíliaBernardes, António2024-02-22T22:32:43Zoai:revista.spcir.com:article/717Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:10:53.879189Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
THE VALUE OF INFLAMMATORY MARKERS FOR DIAGNOSIS AND INDICATION OF SEVERITY OF ACUTE APPENDICITIS O VALOR DOS MARCADORES INFLAMATÓRIOS PARA O DIAGNÓSTICO E INDICAÇÃO DO GRAU DE SEVERIDADE DE APENDICITE AGUDA |
title |
THE VALUE OF INFLAMMATORY MARKERS FOR DIAGNOSIS AND INDICATION OF SEVERITY OF ACUTE APPENDICITIS |
spellingShingle |
THE VALUE OF INFLAMMATORY MARKERS FOR DIAGNOSIS AND INDICATION OF SEVERITY OF ACUTE APPENDICITIS Melo, Catarina |
title_short |
THE VALUE OF INFLAMMATORY MARKERS FOR DIAGNOSIS AND INDICATION OF SEVERITY OF ACUTE APPENDICITIS |
title_full |
THE VALUE OF INFLAMMATORY MARKERS FOR DIAGNOSIS AND INDICATION OF SEVERITY OF ACUTE APPENDICITIS |
title_fullStr |
THE VALUE OF INFLAMMATORY MARKERS FOR DIAGNOSIS AND INDICATION OF SEVERITY OF ACUTE APPENDICITIS |
title_full_unstemmed |
THE VALUE OF INFLAMMATORY MARKERS FOR DIAGNOSIS AND INDICATION OF SEVERITY OF ACUTE APPENDICITIS |
title_sort |
THE VALUE OF INFLAMMATORY MARKERS FOR DIAGNOSIS AND INDICATION OF SEVERITY OF ACUTE APPENDICITIS |
author |
Melo, Catarina |
author_facet |
Melo, Catarina Melo, Fernando Fraga, Emília Bernardes, António |
author_role |
author |
author2 |
Melo, Fernando Fraga, Emília Bernardes, António |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Melo, Catarina Melo, Fernando Fraga, Emília Bernardes, António |
description |
Introduction: The purpose of this work was to recognise the value of clinical manifestations and laboratory tests to establish the diagnosis of acute appendicitis and the severity of histopathology findings. Materials and methods: This study evaluated 272 patients surgically treated for acute appendicitis, mean age 40 years old, between 2012 and 2013. Clinical and laboratory parameters were collected and then correlated with results of histopathology. Results: Histopathology confirmed the diagnosis of acute appendicitis in 238 (87.5%) cases: phlegmonous in 32, suppurative in 164, gangrenous/perforated in 42. No statistical difference was found in clinical manifestations between the group with confirmed acute appendicitis and the group with normal appendix. The leucocyte count was significantly superior in the group with confirmed acute appendicitis, however was not statistically different between the histological types. Leucocyte count of 10850x106/L showed discriminative power between normal appendix and inflamed appendix with a sensitivity, specificity and positive predictive value of 84.6%, 76,1% and 98.9% respectively. The C-Reactive protein was related to the severity of the inflammation, and a value of 5,27mg/dl was correlated with gangrenous/perforated appendicitis. Discussion/Conclusions: Leucocyte count superior than 10850x106/L can support the diagnosis of acute appendicitis when clinical suspicion exists. C-Reactive protein is related to the severity of inflammation. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-09-30 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.34635/rpc.717 https://doi.org/10.34635/rpc.717 |
url |
https://doi.org/10.34635/rpc.717 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://revista.spcir.com/index.php/spcir/article/view/717 https://revista.spcir.com/index.php/spcir/article/view/717/560 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2020 Revista Portuguesa de Cirurgia info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2020 Revista Portuguesa de Cirurgia |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
dc.source.none.fl_str_mv |
Revista Portuguesa de Cirurgia; No 48 (2020): Number 48 - September 2020; 25-32 Revista Portuguesa de Cirurgia; No 48 (2020): Number 48 - September 2020; 25-32 2183-1165 1646-6918 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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