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  • Title: Diagnosis of appendicitis in childhood.
    Author: Harland RN.
    Journal: J R Coll Surg Edinb; 1991 Apr; 36(2):89-90. PubMed ID: 2051426.
    Abstract:
    A retrospective study of the diagnostic value of the blood white cell count was carried out in 187 children who had had an appendicectomy for suspected appendicitis. All had preoperative measurement of the total white cell count. Normal appendices were present in 43 children (23%), with a mean white cell count of 9.5 x 10(6)/l (95% confidence interval 8.4-10.6). The 144 children with appendicitis had a mean white cell count of 16.1 x 10(6)/l (95% confidence interval 15.3-16.9). A white cell count of 10 x 10(6)/l gave the best discrimination, and 91% of patients with a white cell count which equalled or exceeded this value had appendicitis compared with 27% of patients with a lower total white cell count (P less than 0.0001). Only one patient of 46 with gangrenous or perforated appendicitis had a white cell count below 10 x 10(6)/l. In children with suspected appendicitis a low white cell count should lead to review of the diagnosis and to further observation when doubt about the need for surgery persists.
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