Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 20 May 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

White Blood Cell count and temperature in evaluation of suspected appendicitis

October's issue of Academic Emergency Medicine publishes a report that finds no clinical utility for WBC count in cases of suspected appendicitis and minimal statistical association between temperature and presence of appendicitis.

News image

fiogf49gjkf04

The total white blood cell (WBC) count and temperature are often expected to be elevated in patients with appendicitis.

Clinicians often use the results of these parameters in making a judgment about the presence or absence of disease.

Dr Cardall, Dr Glasser and Dr Guss from San Diego, California, assessed the discriminatory value of the total WBC count and presenting body temperature in patients presenting to the emergency department (ED) with signs and symptoms suggestive of appendicitis.

The researchers carried out this prospective consecutive case series in a university ED, with an annual census of 38,000.

The doctors enrolled all patients presenting to the department in whom the diagnosis of appendicitis was the attending physician's primary consideration.

Elevated total WBC count >10,000 cells/mm3 is statistically associated with the presence of appendicitis
Academic Emergency Medicine

The team recorded measures such as age, gender, symptoms, physical findings, patient temperature as taken in the ED, initial total WBC count, and discharge diagnosis.

The admitted patients were followed up by the research group until surgical or clinical outcomes, and discharged patients were followed up by telephone two weeks after the initial visit.

In total, the researchers enrolled 293 patients over a two-year study period.

The doctors measured total WBC count in 274 cases, and temperature in 293 cases.

Out of these participants, 130 were male and 163 were female.

The mean age of the patients was 30.8 years (range, 7–75 years).

The doctors confirmed appendicitis in 92 patients.

The researchers found that an elevated total WBC count >10,000 cells/mm3, while statistically associated with the presence of appendicitis, had very poor sensitivity and specificity and almost no clinical utility.

In addition, there was minimal statistical association between a temperature of >99°F and the presence of appendicitis.

On analysis, the group found that there is no value of total WBC count or temperature that has sufficient sensitivity and specificity to be of clinical value in the diagnosis of appendicitis.

Dr Guss concluded, "Clinicians should be wary of reliance on either elevated temperature or total WBC count as an indicator of the presence of appendicitis."

Academic Emergency Medicine; 2004: 11 (10): 1021-1027
11 October 2004

Go to top of page Email this page Email this page to a colleague

 18 May 2018 
Esophageal dilatation in clinical practice 
 17 May 2018 
IBD and later extraintestinal manifestations
 17 May 2018 
Repeat stool DNA testing
 17 May 2018 
IBS and chronic fatigue following GI infection
 16 May 2018 
Factors associated with fecal incontinence
 16 May 2018 
Diagnostic delay in Crohn's disease
 16 May 2018 
Cardiovascular risk in diabetes mellitus with NAFLD
 15 May 2018 
Guidelines for management of Crohn's
 15 May 2018 
Hep B in the Grey Zone
 15 May 2018 
New therapies for CDI
 14 May 2018 
Blood test for the diagnosis of fibrotic NASH
 14 May 2018 
Outcomes at bariatric centers of excellence
 14 May 2018 
Management of perianal fistulas in Crohn’s
 11 May 2018 
Detection of undiagnosed celiac disease
 11 May 2018 
Alcohol consumption and drug-induced liver injury
 11 May 2018 
Depressive symptoms in IBD youth
 10 May 2018 
Post‐operative complications in elderly IBD
 10 May 2018 
Colorectal cancer screening
 10 May 2018 
Fibrosis in patients with chronic hepatitis B
 09 May 2018 
Fecal incontinence
 09 May 2018 
Health problems and IBS
 09 May 2018 
Esophageal dilatation in clinical practice 
 07 May 2018 
Omitting antibiotics in uncomplicated acute diverticulitis
 07 May 2018 
Health problems and IBS
 07 May 2018 
Assessment of diminutive colorectal polyps
 04 May 2018 
Factors associated with fecal incontinence
 04 May 2018 
National Institutes of Health workshop and obesity
 04 May 2018 
Colorectal cancer screening and ethnic inequities
 03 May 2018 
Gastrointestinal ultrasound in IBD
 03 May 2018 
PPI use and cognitive decline
 03 May 2018 
Ultransonography in postsurgical recurrence in Crohn's
 02 May 2018 
Symptom assessment in cirrhotic ascites
 02 May 2018 
Hep C antiviral treatment and liver cancer risk
 02 May 2018 
Chronic Hep B
 01 May 2018 
European guidelines on pancreatic cystic neoplasms
 01 May 2018 
Interferon‐free regimens in Hep C
 01 May 2018 
Age at IBD onset and extraintestinal complications
 30 April 2018 
Formula for preterm infants
 30 April 2018 
Primary antibiotic resistance and sequential therapy for H. pylori
 30 April 2018 
Patient-reported outcome measures in IBD trials
 27 April 2018 
Anxiety scale for chronic esophageal disease
 27 April 2018 
Disease activity in eosinophilic esophagitis
 27 April 2018 
Eastern and western practices for endoscopic resection of colorectal lesions
 26 April 2018 
Obesity and physical activity in diverticulosis
 26 April 2018 
Fecal incontinence and quality of life in IBD
 26 April 2018 
Primary sclerosing cholangitis in the USA
 25 April 2018 
Aspirin and pancreatic cancer
 25 April 2018 
Central mediators of irinotecan-induced steatohepatitis
 25 April 2018 
Neuroimaging in Hep C
 24 April 2018 
Scoring system identifies cancer risk in Barrett's
 24 April 2018 
Microbiome in athletes vs sedentary subjects
 24 April 2018 
PPI and risk of stroke
 23 April 2018 
Genome-wide study on HBV-related acute-on-chronic liver failure
 23 April 2018 
Antibody suitable for further clinical development to complement existing therapeutic strategies for HCV
 23 April 2018 
Sleep deprivation and NAFLD in the USA
 20 April 2018 
Two annexin A11 epitopes targeted by IgG1 and IgG4 autoantibodies were shared between patients with IAC/AIP and IgG4 antibodies blocked binding of IgG1 antibodies to the shared annexin A11 epitopes
 20 April 2018 
Adalimumab with azathioprine in Crohn's
 20 April 2018 
Worldwide H.pylori prevalence
 19 April 2018 
c-Myc expression and pancreatic cancer
 19 April 2018 
Olmesartan prescription in the USA

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us