INTRODUCTION
Acute appendicitis (AA) is the most common cause of surgery performed
for acute abdomen (1). While the lifetime risk of AA is 12% in men, it
is around 23% in women, and it is most common in the second and fifth
decades (2). Anamnesis and physical examination are the basic steps for
the diagnosis of AA. Laboratory parameters, ultrasonography, and
computed tomography (CT) are auxiliary methods in diagnosis (3). The
standard treatment for AA patients has been appendectomy for more than a
century to prevent severe complications such as perforation,
intra-abdominal infection, and sepsis. Owing to the progress made in
imaging methods over time and the widespread use of abdominal CT, it can
be clearly understood whether appendicitis is complicated. In addition
to this, with the use of broad-spectrum antibiotics, the medical
treatment option has come to the fore in the treatment of uncomplicated
AA (4). In the guideline published by the World Emergency Surgery
Society in 2016, it was reported that patients who were diagnosed with
uncomplicated AA but did not want to undergo surgery can be treated with
antibiotics (5). Complete blood count (CBC) is a widely used laboratory
test in the diagnosis of AA in emergency services. White blood cell
(WBC) and neutrophil levels are the earliest inflammatory markers during
AA. However, its sensitivity and specificity are quite variable
according to the duration of the symptoms and the cut off values used.
Thus, studies have been conducted in which platelet distribution width
(PDW), red cell distribution width (RDW), platelets count (PLT), and
mean platelet volume (MPV) values in CBC can be used in the diagnosis of
AA (6). Platelets play an important role in the inflammation process.
Indexes such as MPV and PDW are related to platelet activation and
morphology (7). MPV refers to the mean size of circulating platelets,
and this mean size increases with inflammation. Due to the change in
platelet shape during platelet activation, pseudopod formation occurs
and the amount of PDW increases (8). RDW is a measure of the variability
in size of red blood cells and increases in inflammatory events (9).
In this study, we aimed to evaluate whether WBC, platelet count, MPV,
PDW, RDW, and C-reactive protein (CRP) values of patients diagnosed with
uncomplicated AA clinically, with laboratory tests and radiologically
with abdominal CT could be a marker for choosing medical or surgical
treatment.