Is neutrophilia the key to diagnosing appendicitis in pregnancy?
| Autor: | Adrienne L. Melck, Cameron J. Hague, Gabriela Meglei, Leo Chen, J. Quinn Gentles |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Abdominal pain medicine.medical_specialty Adolescent Neutrophils Sensitivity and Specificity Gastroenterology 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Pregnancy Risk Factors Internal medicine Left shift medicine Appendectomy Humans Retrospective Studies 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Magnetic resonance imaging General Medicine Appendicitis medicine.disease Magnetic Resonance Imaging Neutrophilia Pregnancy Complications Alvarado score Intestinal Perforation 030220 oncology & carcinogenesis Acute Disease Absolute neutrophil count Female Surgery medicine.symptom business |
| Zdroj: | The American Journal of Surgery. 219:855-859 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2020.03.018 |
| Popis: | The diagnosis of acute appendicitis (AA) in pregnancy remains challenging. We investigated which preoperative clinical factors are most predictive of AA in pregnant women.164 pregnant patients undergoing magnetic resonance imaging for suspected AA were retrospectively reviewed. Logistic regression was used to compare those with pathologically confirmed AA and those without.28 patients (17.1%) had pathologically confirmed AA. 42.9% (n = 12) were perforated at the time of operation. Factors associated with AA included history of emesis (p = 0.005), migratory abdominal pain (p = 0.006), rebound tenderness (p = 0.01), elevated white blood cell count (p = 0.003), elevated Alvarado Score (p 0.001), elevated neutrophil count (p = 0.021), and left shift (p = 0.001). As a screening test, a left shift with neutrophils70% provided a sensitivity and negative predictive value of 100.0%.Every patient in our series with AA had a left shift. Neutrophil count and percentage should be considered in the diagnostic evaluation of these patients to better guide resource utilization and treatment. |
| Databáze: | OpenAIRE |
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