Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

Original Article
Comparison of inflammatory markers in the differentiation of uncomplicated appendicitis and complicated appendicitis
Aim: Appendicitis is the common emergency surgery performed in the pediatric age group. In our study, it was aimed to compare the pre-operative inflammatory markers with the pathology results of the patients who were operated for appendicitis in our clinic and to reveal their success in the distinction between uncomplicated appendicitis and complicated appendicitis. Material and Method: The data of 98 patients who were operated with a pre-diagnosis of appendicitis in the pediatric surgery clinic of our hospital between 2019 and 2021 were retrospectively analyzed. Uncomplicated appendicitis and complicated appendicitis grouping was made according to pathological diagnoses. The inflammatory markers were evaluated. Results: According to the pathological grouping, 51 (56.7%) patients are in the uncomplicated appendicitis group. It was observed that only the change in the C-reactive protein (CRP) value in the binary regression evaluation created for the parameters whose difference was significant evaluation increased the complicated appendicitis probability 1.028 times. It was seen that the CRP value of 34.65 was a parameter that could distinguish between uncomplicated appendicitis and complicated append with 79.5% sensitivity and 78.4% specificity. Conclusion: The treatment of appendicitis in children is a subject that is still being studied and has many points that have not been clarified. Among the markers that can be used in treatment planning, CRP gives usable results.

1. Glass CC, Rangel SJ. Overview and diagnosis of uncomplicatedappendicitis in children. Semin Pediatr Surg 2016; 25: 198-203.
2. Podda M, Gerardi C, Cillara N, et al. Antibiotic treatment andappendectomy for uncomplicated acute appendicitis in adults andchildren: a systematic review and meta-analysis. Ann Surg 2019; 270:1028-40.
3. Cheng Y, Xiong X, Lu J, Wu S, Zhou R, Cheng N. Early versus delayedappendicectomy for appendiceal phlegmon or abscess. CochraneDatabase Syst Rev 2017; 6: CD011670.
4. Craig S, Dalton S. Diagnosing appendicitis: What works, what does notand where to go from here?. J Paediatr Child Health 2016; 52: 168-73.
5. Fujii T, Tanaka A, Katami H, Shimono R. Usefulness of the pediatricappendicitis score for assessing the severity of acute appendicitis inchildren. Pediatr Int 2020; 62: 70-3.
6. Macco S, Vrouenraets BC, de Castro SM. Evaluation of scoring systemsin predicting acute appendicitis in children. Surgery 2016; 160: 1599-604.
7. Yu CW, Juan LI, Wu MH, Shen CJ, Wu JY, Lee CC. Systematic reviewand meta-analysis of the diagnostic accuracy of procalcitonin, C-reactiveprotein and white blood cell count for suspected acute appendicitis. Br JSurg 2013; 100: 322-9.
8. Sevinç MM, Kınacı E, Çakar E, et al. Diagnostic value of basic laboratoryparameters for simple and perforated acute appendicitis: an analysis of3392 cases. Ulus Travma Acil Cerrahi Derg 2016; 22: 155-62.
9. Mathews EK, Griffin RL, Mortellaro V, et al. Utility of immaturegranulocyte percentage in pediatric appendicitis. J Surg Res 2014; 190:230-4.
10. Unal Y. A. New and early marker in the diagnosis of acute complicatedappendicitis: immature granulocytes. Ulus Travma Acil Cerrahi Derg2018; 24: 434-9.
11. Caruso AM, Pane A, Garau R, et al. Acute appendicitis in children: notonly surgical treatment. J Pediatr Surg 2017; 52: 444-8.
12. Miyauchi H, Okata Y, Hatakeyama T, Nakatani T, Nakai Y, Bitoh Y.Analysis of predictive factors for perforated appendicitis in children.Pediatr Int 2020; 62: 711-5.
13. Avanesov M, Wiese NJ, Karul M, et al. Diagnostic prediction of complicatedappendicitis by combined clinical and radiological appendicitis severityindex (APSI). Eur Radiol 2018; 28: 3601-10.
14. Pham XD, Sullins VF, Kim DY, et al. Factors predictive of complicatedappendicitis in children. J Surg Res 2016; 206: 62-6.
15. Yu CW, Juan LI, Wu MH, Shen CJ, Wu JY, Lee CC. Systematic reviewand meta-analysis of the diagnostic accuracy of procalcitonin, C-reactiveprotein and white blood cell count for suspected acute appendicitis. Br JSurg 2013; 100: 322-9.
16. Nah EH, Kim S, Cho S, Cho HI. Complete blood count reference intervalsand patterns of changes across pediatric, adult, and geriatric ages in Korea.Ann Lab Med 2018; 38: 503-11.
17. Alnor AB, Vinholt PJ. Paediatric reference intervals are heterogeneousand differ considerably in the classification of healthy paediatric bloodsamples. Eur J Pediatr 2019; 178: 963-71.
18. Celik B, Nalcacioglu H, Ozcatal M, Altuner Torun Y. Role of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in identifyingcomplicated appendicitis in the pediatric emergency department. UlusTravma Acil Cerrahi Derg 2019; 25: 222-8.
19. Pehlivanlı F, Aydin O. Role of platelet to lymphocyte ratio as a biomedicalmarker for the pre-operative diagnosis of acute appendicitis. Surg Infect(Larchmt) 2019; 20: 631-6.
20. Cimenti C, Erwa W, Herkner KR, Kasper DC, Müller W, Resch B. Thepredictive value of immature granulocyte count and immature myeloidinformation in the diagnosis of neonatal sepsis. Clin Chem Lab Med 2012;50: 1429-32.
21. Güngör A, Göktuğ A, Tekeli A, et al. Evaluation of the accuracy ofimmature granulocyte percentage in predicting pediatric serious bacterialinfection. Int J Lab Hematol 2021; 43: 632-7
22. Roehrl MH, Lantz D, Sylvester C, Wang JY. Age-dependent referenceranges for automated assessment of immature granulocytes and clinicalsignificance in an outpatient setting. Arch Pathol Lab Med 2011; 135: 471-7.
Volume 2, Issue 4, 2022
Page : 100-103