16155 Viewed2033 Downloaded
Differences in Abdominal Pain Etiology: Is it from Appendicitis or Ovarian Cyst?
Received: 29 Jan 2019 | Accepted: 19 Mar 2019 | Available online: 27 Mar 2019Hüseyin Onur AYDINa, Ebru Hatice AYVAZOĞLU SOYa, Tugan TEZCANERa, Mahir KIRNAPa
aDepartment of General Surgery, Başkent University Faculty of Medicine, Ankara, TURKEY
J Clin Obstet Gynecol. 2019;29(2):57-61
DOI: 10.5336/jcog.2019-65063
Article Language: EN
Copyright Ⓒ 2024 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (
http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: In childbearing age, abdominal pain presents a unique diagnostic dilemma. These patients are often evaluated by a general surgeon and gynecologist to determine pain etiology. The aim of this study was to compare the preoperative parameters in patients with ovarian cysts, evaluate the negative appendectomy factors in patients undergoing appendectomy with acute appendicitis (AA) diagnosis, and predict negative appendectomy. Material and Methods: The medical records of patients diagnosed with AA between March 2011 and September 2018 were retrospectively evaluated. The patients were categorized into AA and normal appendix (NA) groups on the basis of postoperative pathological outcomes. The preoperative American Society of Anesthesiology scores, Alvarado scores, white blood cell count (WBC), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio, cyst size, and postoperative pathological results were recorded. Results: A total of 86 patients with ovarian cyst were enrolled. In 26 (30%) patients, NA was observed from pathology results. The best cutoff values were determined as 5.5, 11.600 cells/mm3, 4.6, and 19 mm for Alvarado score, WBC, NLR, and cyst size, respectively. Conclusion: Our study determined that the likelihood of AA increases among patients with a higher Alvarado score and WBC count and NLR increases with an increase in the likelihood of NA among patients with a larger cyst size.
REFERENCES:- Boyd CA, Riall TS. Unexpected gynecologic findings during abdominal surgery. Curr Probl Surg. 2012;49(4):195-251. [Crossref] [PubMed] [PMC]
- Vandermeer FQ, Wong-You-Cheong JJ. Imaging of acute abdominal pain. Clin Obstet Gynecol. 2009;52(1):2-20. [Crossref] [PubMed]
- Song JY, Yordan E, Rotman C. Incidental appendectomy during endoscopic surgery. JSLS. 2009;13(3):376-83.
- Raziel A, Ron-El R, Pansky M, Arieli S, Bukovsky I, Caspi E. Current management of ruptured corpus luteum. Eur J Obstet Gynecol Reprod Biol. 1993;50(1):77-81. [Crossref]
- Addis DG, Schaffer N, Fowler B, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990;132(5):910-25. [Crossref] [PubMed]
- Farghaly SA. Current diagnosis and managment of ovarian cysts. Clin Exp Obstet Gynecol. 2014;41(6):609-12.
- Pieper R, Kager L, Näsman P. Acute appendicitis: a clinical study of 1018 cases of emergency appendectomy. Acta Chir Scand. 1982;148(1):51-62.
- Hallan S, Asberg A, Edna TH. Additional value of biochemical test in suspected acute appendicitis. Eur J Surg. 1997;163(7):5338.
- Keskek M, Tez M, Yoldas O, Acar A, Akgul O, Gocmen E, et al. Receiver operating characteristic analysis of leukocyte counts in operations for suspected appendicitis. Am J Emerg Med. 2008;26(7):769-72. [Crossref] [PubMed]
- Alvarado A. A practical score for early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15(5):557-64. [Crossref]
- Al-Fouri AF, Ajarma KY, Al-Abbadi AM, Al-Omari AH, Almunaizel TS, Alzu?bi AA, et al. The Alvarado score versus computed tomography in the diagnosis of acute appendicitis: a prospective study. Med J Armed Forces India. 2016;72(4):332-7. [Crossref] [PubMed] [PMC]
- Goodman DA, Goodman CB, Monk JS. Use of the neutrophil: lymohocyte ratio in the diagnosis of appendicitis. Am Surg. 1995;61(3): 257-9.
- Kelly ME, Khan A, Riaz M, Bolger JC, Bennani F, Khan W, et al. The utilitiy of neutrophil-tolymphocyte ratio as a severity predictor of acute appendicitisi length of hospital stay and postoperative complication rates. Dis Surg. 2015;32(6):459-63. [Crossref] [PubMed]
- Kahramanca S, Ozgehan G, Seker D, Gökce EI, Seker G, Tunç G, et al. Neutrophil-tolymphocyte ratio as a predictor of acute appendicitis. Ulus Travma Acil Cerrahi Derg. 2014;20(1):19-22. [Crossref] [PubMed]
- Hoffmann J, Rasmussen OO. Aids in the diagnosis of acute appendicitis. Br J Surg. 1989;76(8):774-9. [Crossref] [PubMed]
- Nemoto Y, Ishihara K, Sekiya T, Konishi H, Araki T. Ultrasonographic and clinical appearance of hemorrhagic ovarian cyst diagnosed by transvaginal scan. J Nippon Med Sch. 2003;70(3):243-9. [Crossref] [PubMed]
- Vercellini P, Fedele L, Aimi G, Pietropaolo G, Consonni D, Crosignani PG. Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of 1000 patients. Hum Reprod. 2007;22(1):266-71. [Crossref] [PubMed]
- Schliep KC, Mumford SL, Peterson CM, Chen Z, Johnstone EB, Sharp JB, et al. Pain typology and incident endometriosis. Hum Reprod. 2015;30(10):2427-38. [Crossref] [PubMed] [PMC]