Diagnostic value of hyperfibrinogenemia as a predictive factor for appendiceal perforation in acute appendicitis

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As one of the most common emergency abdominal inflammation requiring operation, acute appendicitis always leads to systemic inflammatory response syndrome.1 Meanwhile, inflammation can alter the coagulation system through a variety of inflammatory pathways.2 In case of perforated appendix, a variety of potentially serious complications such as bacterial peritonitis, sepsis, small‐bowel obstruction and abdominal abscess may develop. Recently, it was indicated that endotoxin‐induced activation of the extrinsic coagulation pathway was present in patients with acute appendicitis and fibrinogen may be used as a potential marker for predicting appendiceal perforation.3 In a research made by Feng et al.,4 hyperfibrinogenemia was shown to have a predictive value for the diagnosis of appendiceal perforation in children. In this study, we performed a retrospective chart review of 455 adult patients with histologically confirmed acute appendicitis in whom plasma fibrinogen levels were routinely tested before surgery. We expected to evaluate whether there are differences in plasma fibrinogen level in acute appendicitis of different pathological types especially between perforated and non‐perforated appendix.
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