Resumen

LEYBA¹, José Luis; BRAVO¹, Carlos; DEHOLLAIN², Alejandra  y  ISAAC³, José. Proteína C reactiva y apendicitis aguda. Gac Méd Caracas [online]. 2006, vol.114, n.1, pp.17-21. ISSN 0367-4762.

Summary A prospective study is done to assess the value of preoperative C reactive protein serum levels in the diagnosis and prognosis of patients with clinical feature of acute appendicitis. Fifty-two patients were included and divided in uncomplicated appendicitis (edematous and flegmonous phases) or complicated appendicitis (gangrene, perforation and/or purulent peritonitis), depending on the clinical and anatomopatological findings of the surgical specimen. This findings were correlated with the preoperative values of C reactive protein, and also with other clinical and paraclinical parameters (time of evolution, fever, abdominal guarding, leukocytosis, neutrophylia and postoperative morbidity). Twenty-five percent (25 %) of the patients with histologic confirmation of acute appendicitis had normal values of C reactive protein (< 1 mg/dL). The patients with complicated appendicitis had superior C reactive protein levels than the patients with uncomplicated disease, being this difference between both groups statistically significant (P < 0.01). However, inside the group of complicated disease, the C reactive protein values weren’t an independent parameter for postoperative morbidity (P > 0.05). Among the others parameters evaluated, only the fever had enough frequency to predict a complicated stage of the disease. We concluded that the C reactive protein is not a trustworthy test to exclude an acute appendicitis. However elevated levels of this test (> 6 mg/dL) are more frequently associated with complicated stages of the disease. In these patients the start of a combined antibiotic therapy in the same preoperative period as well as the total indication for a laparoscopic approach could allow to minimize the postoperative infectious complications that are more frequent when the appendicitis evolved to a complicated phase

Palabras clave : Acute appendicitis; C reactive protein; Complications.