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Acute appendicitis (AA) is one of the most common surgical disease of the abdomen, but the diagnosis of the disease in an emergency setting still presents some challenges (1). The diagnosis of AA is based on a brief history of abdominal pain, nausea, migration of pain to the right iliac fossa, and signs of local peritonitis; diagnostic certainty based on these symptoms ranges from 70% to 80% (1, 2). The clinical diagnosis is often not easy even for veteran surgeons, as evidenced by the high rate of false explorations, which commonly reaches 20% to 30% (1). It leads to complications like perforation, abscess, sepsis and intestinal obstruction, if diagnosis of acute appendicitis is being late (3). Imaging modalities such as ultrasonography and computerized tomography, as well as diagnostic laparoscopy and recent laboratory tests have been increasingly used for quick and correct diagnosis (4). However, they are not enough (5). Recently some studies have investigated various parameters like C-reactive protein, white blood cell count, lymphocyte/leukocyte rate, erythrocyte sedimentation rate, procalcitonin, fibrinogen, alpha 2macroglobulin, alpha 1-antitrypsin and DLactate for the diagnosis of AA (2) however none of them were commonly accepted. So, simple, widely valid, inexpensive, and time-saving new laboratory methods that can be implemented anywhere are essentially for the diagnosis of AA. Mean platelet volume (MPV) is a common test that is part of complete blood count (6). MPV is ABSTRACT

Mean platelet volume, red cell distribution width, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in the diagnosis acute appendicitis