This retrospective study was conducted at the Department of Paediatric Surgery, University of the Witwatersrand, and included a review of all patients who presented with acute appendicitis between June 2010 and September 2015.
The early stages of infectious diseases caused by bacteria and viruses show NLR changes.25 There are numerous studies indicating that NLR is significant in the differential diagnosis of appendicitis compared to healthy volunteers when it is above 3.5.26,27 In recent years, a number of studies have shown that NLR works in determining the severity of appendicitis.28,29 The present study indicated that the NLR was useful in differentiating acute appendicitis. The reason for this is the fact that the drop of lymphocyte count was more pronounced in the appendicitis group in which the increase in neutrophil count was the highest.
Next day patient complained of increase in intensity of pain, more in lower abdomen and tenderness on both sides of lower abdomen and provisional diagnosis from acute gastritis to acute appendicitis was made and emergency appendicectomy was planned.
Minimal free fluid was observed in the periphery of the intestinal loop in the abdominal right inferior quadrant on the ultrasonography (US) conducted because of the preliminary diagnosis of acute appendicitis. Abdominal tenderness induced by compression of the probe was observed, and a suspicious condition was identified for acute appendicitis.