It has been estimated that the accuracy of the clinical diagnosis of acute appendicitis is only between 76 percent and 92 percent [9, 11]. Thus, accurate diagnosis of acute appendicitis is still difficult [1, 12, 13]. The perforation rate is high, as well as the number of negative appendectomies [9, 14]. Following the introduction of ultrasound scans during the last

two decades and computed tomography (CT) in the last decade, the rate of negative appendectomies has decreased [4, 15–17], but the perforation rate has remained high (22%-62%) [4, 18, 19]. Negative appendectomies are one of the burdens facing not only the general surgeon but also the patient her/himself and society as a whole, since appendectomy, as any other operation, results in socio-economic impacts in the form of lost working days and declined productivity. CRP is a non-specific inflammatory marker that is used routinely in many learn more hospitals as an aid in the diagnosis of patients with an acute abdomen [9, 10, 14]. An acute phase protein

is produced in the liver. Normal serum concentration is less than 10 mg/l 8–12 hours after infection or trauma; the increase of acute phase protein in liver the CRP is more important in clinical practice. Production of CRP is controlled by Interleukin-6 and in a few minutes increases from 10 to 1,000 times. CRP is increased in infections, inflammatory arthritis, autoimmune disorders, neoplasia, pregnancy, and aging [9, 10, 20–24]. Many CB-5083 clinical trial reports have investigated the value of the raised serum CRP measurement in improving the diagnosis of acute appendicitis [9, 10, 25]. Additional tests that would improve the diagnostic accuracy and reduce the number of unnecessary operations are needed. This is particularly

important these days when health planning is driven by cost containment. The C-reactive protein (CRP), together with other acute-phase proteins, increased in response to tissue injury [26]. The aim of this study was to analyze the role of C-reactive protein (CRP) values, in accuracy of diagnosis of acute appendicitis in comparison Thalidomide with WBC, NP, the surgeon’s clinical diagnosis, and the histopathologic findings. Patients and methods Patients The study included randomly all operated patients (173) suspected of acute appendicitis between November 2008 and February 2009 in the Department of Surgery. Methods Clinical signs of acute appendicitis determined by the surgeon and the duration of the symptoms were documented on admission. The clinical signs included direct tenderness in the right lower quadrant, percussion and rebound tenderness, localized rigidity, and diffuse SB525334 rigidity of the abdominal wall. At least one clinical sign had to be present in order to consider the patient positive for clinical signs.