الفهرس 
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Abstract
The diagnosis of acute appendicitis is primarily clinical and should be made on clinical symptoms and signs. However, some patients have equivocal physical findings and may be admitted for a period of observation. We suggest that these patients could also have serial total white cell counts taken as an aid for diagnosis. To avoid perforation of the appendix, most surgeons accept negative appneidectomy rate of 20-25%. We believe with the diagnostic tools available today that is laboratory (C-reactive protein white cell counts and total differential count) and ultrasonography the negative appendectomy rate could be significantly reduced without increase the risk of perforation. These investigations may not increase the number of patients subsequently developing subacute or recurrent appendices. A more conservative attitude toward patients with symptoms suggesting appendicitis might probably be recommended instead of performing emergency surgery on wide indication. Observation in hospital in combination with laboratory tests and perhaps ultrasonography should be resorted to in patient whose diagnosis is doubtful.
The aim of this study is to evaluate the accuracy of change in leukocytic count in comparison with clinical pictures and histopathology in diagnosis of suspected acute appendicitis.
This study included 68 patients with acute lower abdominal pain suspecting acute appendicitis divided into 2 groups A (34 patients) and B (34 patients). Patient will be chosen by closed envelope method. Patients in group A will be with normal leukocytic count and patients in group B will be with high leukocytic count.
All specimens of appendectomies were sent to histopathological examination and then their results were compared to the results of TLC and neutrophils and correlated with clinical pictures.
The results of this study showed that the leukocytic count has a sensitivity of 58%, specificity of 85%, accuracy of 63% and negative appendectomy rate of 19 %.
The results of this study showed that the neutrophils has a sensitivity of 49%, specificity of 92%, accuracy of 57% .
It was found that if total leucocytic count and neutrophile and C reactive protein were high. The diagnostic accuracy of acute appendicitis was more increased in contrast to depending on single item.