Routine Urinalysis in Patients with Acute Appendicitis
摘要
Objective: Acute appendicitis is the most common abdominal surgical emergency. The correlation between abnormal urinalysis and appendicitis is still unclear. Therefore, we aimed to determine whether routine urinalysis may serve as a tool to discriminate between acute appendicitis and perforated appendicitis. Methods: We analyzed retrospectively 714 patients with clinically suspected acute appendicitis who underwent urinalysis followed by appendectomy at the Changhua Christian Hospital, Taiwan, from 2003 to 2005. Urine test strip analysis was analyzed with the automated URISYS 2400. Results: Patients with acute appendicitis had a significantly higher percentage of positive urine ketone bodies (p=0.019), higher specific gravity (p=0.004) and lower urine pH (p=0.005) than patients with normal appendices. In addition, patients with perforated appendicitis had a significantly higher percentage of positive ketone bodies (p=0.003), positive occult blood (p=0.024), positive leukocyte esterase (p=0.003), higher positive white blood cell count (greater than 5/high power field) (p=0.010), higher specific gravity (p=0.003), higher red blood cell counts (p=0.002) and lower pH (p=0.002) than patients with non-perforated (simple) appendicitis. Conclusion: Routine urinalysis may show differences in findings between simple and perforated appendicitis. Clinically, we believe these urine parameters may aid clinicians in decision making for patients with suspected appendicitis.