WOFAPS 2025 8th World Congress of Pediatric Surgery

Teuku Yusriadi ¹, Verrell Christopher Amadeus ², Akhmad Makhmudi ², . Rochadi ², . Gunadi ²

¹ Pediatric Surgery Division, Dr. Zainoel Abidin Hospital, Banda Aceh 23126, Indonesia
² Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr.Sardjito Hospital, Yogyakarta 55281, Indonesia

Background: Appendicitis is a common cause of acute abdomen in children. Approximately 30% of pediatric patients present with atypical signs and symptoms, challenging diagnosis, and surgical decision-making. Procalcitonin (PCT) as a biomarker has gained popularity, especially in developed countries.
Methods: This was a cross-sectional diagnostic study using chi-square and Spearman correlation analysis to evaluate levels of PCT and C-reactive protein (CRP) compared with the gold standard of histopathology. The study included pediatric patients undergoing appendectomy (laparoscopic or open) at Dr. Sardjito Hospital, Yogyakarta, Indonesia, from April 2015 to March 2016.

Results: A total of 66 patients met the inclusion criteria. Diagnostic testing and statistical analysis revealed that in cases of complicated appendicitis, PCT had superior sensitivity and specificity (68.2% and 78.9%, respectively) compared to CRP (64.2% and 75%). PCT was a more effective biomarker for diagnosing complicated appendicitis. Identified cutoff values for acute appendicitis were CRP ≥5 mg/dL and PCT ≥0.6 ng/mL; for complicated appendicitis, CRP ≥20 mg/dL and PCT ≥3 ng/mL. A statistically significant association was found between elevated levels of PCT (p = 0.008) and CRP (p = 0.006) and the occurrence of complicated appendicitis.

Conclusions: Elevated levels of PCT and CRP are associated with complicated appendicitis, with PCT being more sensitive and specific. Incorporating PCT and CRP measurements into clinical practice may improve diagnostic accuracy for complicated appendicitis in the pediatric population.