Investigation of the relationship of blood leukocyte number and CRP level with perforation in children with appendicides with symptom duration over 24 hours

The incidence of perforated appendicitis is high, especially in preschool children. In our study, we will try to show the relationship between perforation and clinical findings such as duration of pain, antibiotic use, physical examination findings, and clinical and WBC, CRP, US, laboratory and radiological findings in pediatric patients who were operated with a pre-diagnosis of appendicitis and were found to have appendix perforation during surgery. Patients aged 0-18 years who were hospitalized in the Pediatric Surgery service between 2015 and 2020 due to abdominal pain and who were found to have perforated appendicitis during the operation were included in the study. The total number of patients included in the study is 238. The patients who underwent surgery were evaluated with preoperative WBC, CRP values, physical examination findings, age, duration of abdominal pain, imaging results and; the characteristics and duration of the operation performed, findings during the operation, postoperative complications, and pathology results were recorded in the patient data form. The data obtained in the study were recorded and analyzed in the IBMSPSS Statistics 24.0 program. A total of 238 patients, including 83 girls and 155 boys, were included in the study. The duration of the patients' abdominal pain ranged from 12 hours to 1 week. The mean age and standard deviation of the patients were found to be 10± 4.4 (minimum 1 year and maximum 18 years). The patients were divided into 3 groups according to their pain duration. The pain duration of the patients in the first group was less than 24 hours (n: 83), the pain duration of the patients in the second group was between 24 and 48 hours (n: 81), and the pain duration of the patients in the last group was longer than 48 hours (n: 74). It was observed that there was a difference between the groups in which variables were compared according to pain duration in terms of CRP and length of stay. CRP was significantly lower in the group with less than 24 hours of abdominal pain (53,6 mg / dL) compared to the other two groups. The length of stay was significantly different in all three groups. The longest hospital stay was in the group with abdominal pain of more than 48 hours with 6 days. The operation time was significantly longer in the third group than the first two groups. It was observed that there was no difference between the rates of appendicitis in US in all three groups. The highest rate of conversion to open surgery was in the group with pain duration longer than 48 hours. As the duration of abdominal pain increases, the severity of symptoms, high CRP, duration of surgery, postoperative complications, and duration of hospital stay increase. In the course after the development of perforation in the patient, evaluation according to age, loses its importance. For this reason, the age factor should be carefully considered in terms of early diagnosis and prevention of perforations.