The Determination of Appendicitis from Folate Acid and Vascular Endothelial Growth Factor Level in Animal Model: A Review

BACKGROUND: Appendicitis is one of the most common abdominal emergencies that require surgery in children. The morbidity and mortality rate in appendicitis is greatly affected by rupture or leakage of the appendix. In establishing the diagnosis of appendicitis, several modalities are acknowledged, namely, pediatric appendicitis score and ultrasound. Pathologically, severity and complications of appendicitis occur related to good vascularization and tissue healing process through process of angiogenesis influenced by folic acid (FA) and vascular endothelial growth factor (VEGF). This is clinically important as currently non-operative and non-invasive therapies were developing in stratification of mild appendicitis.AIM: This study aimed to review the determination of appendicitis from FA and VEGF levels in animal model.METHODS: This study was conducted in accordance with the PRISMA guidelines for reporting systematic reviews. Articles were reviewed for relation of FA and VEGF in determining appendicitis in PubMed and Science Direct. Articles on experimental animal model published from 1990 to 2020 were included, while articles in English were excluded from the study.RESULTS: The articles we reviewed conduct an assessment of appendicitis by FA and VEGF level in animal model. Three articles were reviewed ranging from 1990 to 2020. One article presented a significant association of decreased level of FA in determining appendicitis while the other two mentioned trends of decreased level of FA and VEGF in appendicitis without statistically significance.CONCLUSION: Reduction of folate acid levels could be a critical prescient factor for the weight of muddled an appendicitis in animal model, however, there was a pattern demonstrating low estimation of VEGF as an indicator of appendicitis and convoluted appendix with no measurable note worthiness appeared.