HISTOPATHOLOGICAL STUDY OF ACUTE APPENDICITIS, THE ROLE OF NEUTROPHIL TO LYMPHOCYTE RATIO IN ITS DIAGNOSIS

Abstract

Acute appendicitis is one of the commonest surgical emergencies. The diagnosis is stilldoubtful in a number of cases. Neutrophil/Lymphocyte ratio (N/L R) is a simple, applicablehematological test which carried out to find if there is any relationship between this ratio andacute appendicitis and to see could the ratio be used as a diagnostic tool rather than whiteblood cell count (WBC) alone.This study was carried out on 70 patients aged (9-45) years who was admitted to hospital withsuspicion of acute appendicitis, latter on, they underwent appendectomy. Preoperative bloodsample was collected from each patient for WBC and differentials leukocyte count.Postoperatively appendectomy specimens were taken to histopathological examination, whichshows 52 cases of inflamed appendix and 18 normal appendices.When the (N/L R) and (WBC) were correlated with results of histopathology, it was found thatthere is a relationship between acute appendicitis and (N/L R), especially if we use the ratio atcut off point which was>2.6(p value<0.05=0.0001), The sensitivity was 80.76% while thespecificity was 72.22% and accuracy was 78.57%, while the results showed that the (WBC)alone had a limited role in diagnosis of acute appendicitis (p value >0.05=0.219).In conclusion, there is a strong relationship between (N/L R) and acute appendicitis.