الفهرس 
Anatomy and EmbryologyOnly 14 pages are availabe for public view
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Abstract
Acute appendicitis represents one of the most common abdominal emergencies in children. If untreated can lead to generalized peritonitis. It is often difficult and challenging even for the most experienced surgeon to make a definite diagnosis in pediatric patients. Inflammatory markers like Total Leukocyte count (TLC) and C-reactive protein (CRP) and Neutrophil Ratio (NR) can help in making an early and accurate diagnosis in difficult cases. Objective: To evaluate the importance of serum CRP level estimation, TLC and Neutrophils ratio in the accurate diagnosis of acute appendicitis, by comparing with the final histopathological diagnosis. Study Design: This study was designed to be a cross-sectional study with non-probability purposive sampling. Subjects and Methods: This study was performed on 50 patients who have been clinically diagnosed as acute appendicitis on the basis of presenting symptoms and signs and who were posted for appendectomy in Department of General Surgery of Shibin El-kom Teaching hospital El Menofya, Egypt in the period of 1st January 2013 to 31st July 2014. All patients from 4-18 years of age fulfilling the inclusion criteria were admitted for this study. We estimated pre-operative serum CRP level, TLC and Neutrophil Ratio in all patients. Postoperatively the histological results were differentiated into non-inflammed and inflamed appendix. Results: The mean age of the patients was 11.8 ±3.2 years. Histopathology showed that 40(80 %) patients had inflamed appendix. Diagnostic accuracy of WBC count, neutrophil ratio and C-reactive protein was 74%, 72% and 88% respectively. Diagnostic accuracy of combining C-reactive protein, WBC count and neutrophil ratio was 100%. Conclusion: TLC and C-reactive protein and neutrophils ratio can provide help in making accurate diagnosis of acute appendicitis. The significance of combining the tests and their role in diagnosing acute appendicitis is found to be very high