International Surgery Journal | May 2019 | Vol 6 | Issue 5 Page 1761 International Surgery Journal Choudhary SK et al. Int Surg J. 2019 May;6(5):1761-1766 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Diagnostic value of C-reactive protein as a predictor of complicated appendicitis like perforated/gangrenous appendicitis Suresh Kumar Choudhary, Bhanwar Lal Yadav*, Shalu Gupta, Narender Kumar, Somendra Bansal, Pradeep Kumar Verma INTRODUCTION Appendicitis is a condition characterized by inflammation of appendix. The crude incidence of acute appendicitis was 86 per 100,000 per year. Although the incidence of nonperforated appendicitis was highest among adolescents and young adults (13-40 years of age), perforated appendicitis occurred at almost the same incidence in all sex and age groups. Acute abdominal pain is one of most common surgical emergencies. Appendicitis remains the most common abdominal surgical emergency with a life time prevalence of one in seven. 1 There is no reliable specific marker for acute appendicitis and is a reminder for the art of surgical diagnosis. It has been shown that appendicular abscess occurs in 2-6% and appendicular perforation in 25.8% of untreated patients. 2 In the continued absence of a 100% accurate test for appendicitis, any investigation that can contribute to its diagnosis is valuable. C- reactive protein is an acute phase reactant, which rises rapidly in response to tissue injury and can be measured in serum 6-12hours after the onset of inflammation. Many studies have investigated the role of CRP in ABSTRACT Background: Appendicitis is inflammation of appendix. Appendicitis remains the most common abdominal surgical emergency. There is no reliable specific marker for acute appendicitis and its complications. C- reactive protein is an acute phase reactant produced by the liver during the acute inflammation, which rises rapidly in presence of inflammation. CRP is a more sensitive and reliable indicator of inflammatory processes than ESR and leucocyte count. The aim of this study was to evaluate whether CRP predict the severity of appendicitis. Methods: This study was hospital based, observational study. After history and clinical examination, patient underwent USG whole abdomen. Diagnosis of appendicitis was established. After that patient underwent routine blood investigations including, CRP. After confirming diagnosis of appendicitis, patients underwent appendectomy and biopsy of appendix was sent for histopathological examination. Results: In our study, CRP value > 6.15mg/L has a sensitivity of 100.0% and a specificity of 54% in predicting complicated perforated or gangrenous appendicitis. The positive predictive value and negative predictive value of CRP were 100% and 61.54% respectively. The cut off level at around 6mg/dL needs to be handled carefully and a person with high CRP should undergo surgery immediately. Conclusions: This study clearly suggested that CRP leads to precise prediction of the severity of acute appendicitis for treatment. A person with high CRP should undergo surgery immediately ures. Keywords: C- reactive protein, Inflammation, Perforated/gangrenous appendicitis Department of Surgery, SMS Medical College and Attached Hospitals, Jaipur, Rajasthan, India Received: 11 February 2019 Revised: 24 March 2019 Accepted: 28 March 2019 *Correspondence: Dr. Bhanwar Lal Yadav, E-mail: dr.bhanwar.yadav@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20191903