대한대장항문학회

Purpose: The total white blood cell count is an unreliable predictor of appendicitis. We focused on the leukocyte count and neutrophil/lymphocyte ratio related to the severity of inflammation for better preoperative diagnosis. Methods: Five<br>hundred<br>and<br>fifty seven patients with acute appendicitis operated at Kangwon National University Hospital were reviewed retrospectively. Cases were classified into 4 groups according to the pathological grade of inflammation, those are focal (AF),<br>suppurative<br>(AS),<br>gangrenous (AG), and no diagnostic abnormality (NDA). The leukocyte count and neutrophil/lymphocyte ratio were compared according to groups and presence of periappendiceal abscess.<br>Results: Male to female ratio was 1.13：1 and 2nd and 3rd decades were the most prevalent. Histopathologically, AF cases were 6.3%, AS were 51.29%, AG were 23.9% and NDA were 18.7%. The leukocyte count was abnormally elevated in 411 patients<br>(73.8%).<br>The average counts of leukocyte were different statistically between AS & AG, AF, and NDA (p＜0.001) (9,676/mm3 in NDA, 11,591/mm3 in AF, 13,235/mm3 in AS, and 13,601/mm3 in AG). The neutrophil/lymphocyte ratio was 3.11 in NDA, 3.89 in AF, 5.20<br>in<br>AS,<br>and 6.69 in AG. The value was also statistically significant between NDA & AF, AS, and AG groups (p＜0.001). Using an upper limit of 3.5, it was found that there is a linear trend in NA (0.46), AF (0.75), AS (1.94), and AG (5.65) (p＜0.001). The<br>leukocyte count of 85 cases with periappendiceal abscess was 13,190/mm3, and that of remains 12,440/mm3 (p＞0.05). The average of neutrophil/lymphocyte ratio of 85 cases with periappendiceal abscess was 6.37, and that of remains 4.85 (p＜0.001).<br>Conclusions: The leukocyte count and neutrophil/lymphocyte ratio may be sensitive parameters for severity of inflammation, and the severity of inflammation in appendix show relation with leukocyte count, and the leukocyte count was valuable for<br>predicting the severity of inflammation in appendix.<br>