Role of White blood cell count in Diagnostic accuracy of Acute Appendicitis

Objective: To assess the role of white blood cell count (WBC) in the diagnosis of acute appendicitis and its relation to histopathological findings. Methodology: A descriptive cross sectional study was conducted at Aziz Fatimah Hospital Faisalabad. One hundred patients with acute appendicitis were encompassed in our work. Diagnosis was confirmed after careful clinical assessment aided with classical sign and symptoms. White Blood cell count of every patient was done from laboratory of our hospital. Specimen of appendix of every patient was sent for histopathology. In addition, pre-operative white blood cell count (WBC) was compared with postoperative histopathology reports to assess WBC count's significance in the identification of acute appendicitis. Results: Out of 100 cases, 63 were male, and 37 were females. Age of the patients was between 12 to 55 years, mean age being 20.9 years. Commonest age group was 17 to 30 years (n=73). The sensitivity and specificity of WBC count were calculated 27% and 43.75% respectively, while positive and negative predictive value was 71.87 and 10.1%, respectively. Mean ± SD of TLC of patients with normal and inflamed appendix was 10781±291.0 and 95908 ± 329.43respectively, this difference was not statistically different (p value=0.16). Neutrophils count was 66. 86% in patients with inflamed appendix and nearly equal to this 65.18% was noticed with normal appendix on histopathology (p value=0.15). Odd Ratio were insignificant showing WBCs are nor independent predictors of acute appendicitis (p value 0.30) Conclusion: White blood cell count is not a very good and reliable investigation for diagnosis of acute appendicitis. Patient can be having acute appendicitis with normal white blood cell count.