What is the role of CBC count in the workup of pediatric appendicitis?

Updated: Oct 25, 2018
  • Author: Adam C Alder, MD; Chief Editor: Carmen Cuffari, MD  more...
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The WBC count becomes elevated in approximately 70-90% of patients with acute appendicitis. However, the WBC count is elevated in many other abdominal conditions, as well. Furthermore, the WBC count is often within the reference range within the first 24 hours of symptoms. Elevation tends to occur only as the disease process progresses, and it is usually mild. Therefore, its predictive value is limited. Elevation of the neutrophil or band count can be seen without elevation of the total WBC count and may support the diagnosis of appendicitis.

If the WBCs exceed 15,000 cells/μL, the patient is more likely to have a perforation. However, one study found no difference in the WBC counts of children with simple appendicitis and those with perforated appendicitis. In the immunocompromised patient, a neutrophil count of less than 800 may suggest typhlitis.

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