Differential Diagnosis of Appendicitis on Admission

Acute appendicitis is a common condition requiring urgent surgery but is often difficult to distinguish from other non-surgical conditions such as urinary infections, pelvic inflammatory disease and non-specific abdominal pain. Delay in diagnosis can result in significant morbidity and potential mortality. Currently, there is no one diagnostic test available and raised inflammatory markers such as C-reactive protein and White Blood Count along with an evolving clinical picture help guide management. However, these markers are slow to respond to inflammation and are non-specific for appendicitis. The blood is however richer in markers of inflammation and infection. The Complement cascade is an immune response to inflammation and infection involving three pathways which activate a number of proteins in the blood. Monitoring the absolute levels of these proteins should provide a faster diagnostic test for appendicitis and any underlying infection.

We are currently performing a trial to assess the performance of a number of biomarkers for the rapid diagnosis of appendicitis on admission.


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