{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:18:51Z","timestamp":1789676331795,"version":"4.0.1"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>The aim is to compare the diagnostic accuracy of laboratory investigations and ultrasonography (USG) in distinguishing complicated appendicitis (C-AA) from uncomplicated appendicitis (UC-AA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      Forty-six children who underwent appendicectomy at our center between November 2018 and July 2020 were included. Based on intraoperative findings, they were divided into two groups \u2013 complicated (perforated, gangrenous, or associated with fecal peritonitis;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 18) and UC-AA (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 28). USG findings and inflammatory markers were compared in both groups at admission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      At admission, the mean values for total leukocyte count (TLC) (16090.56 vs. 11739.29 per mm\n                      <jats:sup>3<\/jats:sup>\n                      ), high sensitivity C-reactive protein (hsCRP) (35.8 vs. 31.62 mg\/L), and procalcitonin (PCT) (3.83 vs. 1.41 ng\/mL) were significantly higher in C-AA. Visualization of a blind tubular aperistaltic structure was the only sonographic sign showing statistical significance \u2013 significantly lower in C-AA (50% vs. 90%). Independent predictors of C-AA were \u2013 duration of symptoms &gt;48 h (odds ratio [OR] 6.3), free fluid\/loculated collection in right iliac fossa (OR 3.75), TLC &gt;11000\/mm\n                      <jats:sup>3<\/jats:sup>\n                      (OR 3.6), hsCRP &gt;35 mg\/L (OR 6.0), PCT &gt;0.6 ng\/mL (OR 4.02), and nonvisualization of appendix on USG (OR 8.33). Biochemical factors were sensitive (89%) and specific (55%) in differentiating C-AA from UC-AA but the addition of sonological parameters significantly improved the specificity of predicting complicated AA to 61% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0036).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Combining laboratory data with sonological findings significantly improves the predictive value for differentiating C-AA from UC-AA and can help decide operative approach and prognosticating.<\/jats:p>\n                  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