Leucocyte count and oral temperature are a useful guide to selecting women with right iliac fossa pain for diagnostic laparoscopy.

Annals of the Royal College of Surgeons of England
D Singh-Ranger, A Ogadegbe

Abstract

In women, negative appendicectomy rates can be as high as 34%. A 5-fold reduction is possible with diagnostic laparoscopy. A selective policy is favoured as indiscriminate use may increase postoperative morbidity. Scoring systems are helpful but not used widely due to their complexity. The value of leucocyte count and temperature in selecting women with right iliac fossa pain for diagnostic laparoscopy is investigated. Over a 12-month period, admission leucocyte count and temperature data were obtained from women undergoing appendicectomy. Cohorts were sub-categorised by age (< 20, 21-40 and > 40 years) and the proportion of negative (normal appendix) and positive (inflamed, gangrenous or perforated appendix) appendicectomies compared. In 100 women, 11% had leucocyte counts and temperature > or = 11 x 10(9)/l and 38 degrees C, respectively; all had appendicitis. In 50%, leucocyte counts and temperature were > or = 11 x 10(9)/l and < 38 degrees C; negative appendicectomies occurred in 13.8% < 20 years, 10% > 40 years (P < 0.01) and 27.3% aged 21-40 years (P = 0.086). In 39%, the negative appendicectomy rate was > or = 36.8% when leucocyte count and temperature were < 11 x 10(9)/l and 38 degrees C (P = 0.1). Diagnostic laparoscop...Continue Reading

Citations

Jan 29, 2013·World Journal of Surgery·Thomas MosedaleAneel Bhangu
Feb 14, 2012·International Journal of Surgery·Aneel BhanguRajan Patel

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