Are Average Platelet Volume (MPV), Red Cell Distribution Width (RDW) and
Platelet Distribution Width (PDW) Guiding Markers for Acute Appendicitis
Treatment Options?
Abstract
Background: Acute appendicitis (AA) is the most common cause of surgery
performed for acute abdomen. The standard treatment for AA patients has
been appendectomy for more than a century. use of broad-spectrum
antibiotics, the medical treatment option has come to the fore in the
treatment of uncomplicated AA. Aim: 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. Material and Method: 519 patients aged between 20
and 65 years who were diagnosed with uncomplicated AA by abdominal CT in
our centre between January 2016 and January 2019 were retrospectively
analysed. . The presence of at least one of the criteria of 7 mm or more
appendix diameter and oedema or fluid accumulation around the appendix
was accepted as uncomplicated AA. After the diagnosis of AA, 223
patients were treated medically, while 296 patients underwent
laparoscopic appendectomy. The first group included patients who were
treated medically and the second group included patients who underwent
laparoscopic appendectomy. Results: Group 2 patients had higher mean
platelet count (p <.005) and RDW (p = .003) values compared to
Group 1 patients, while mean PDW (p <.001) values were lower
compared to those of Group 1 patients. The differences between the mean
WBC, CRP and MPV values of the groups were not statistically significant
(p>0.05). Conclusions: The standard treatment for acute
appendicitis is surgery. Recently, studies supporting antibiotic therapy
have been conducted in patients diagnosed with AA. As a result, we think
that PDW, RDW, and platelet values in patients diagnosed with
uncomplicated AA may be a guide in choosing patients to be treated with
surgery or antibiotics. Key Words: acute appendicitis, laparoscopic
appendectomy, antibiotic therapy.