الفهرس 
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Abstract
Acute appendicitis is one of the most common situations that require emergency surgery. Not delaying diagnosis is important but negative appendectomy operation rate is also high in most series. The fact that acute appendicitis presents with different complaints can lead to a delay in diagnosis, which also increases the likelihood of perforation. Negative appendectomy rates are reported to be between 13% and 34% in most series. Diagnostic parameters to reduce the negative appendectomy rate, clinical scoring and imaging techniques in the diagnosis of appendicitis are under investigation. A scoring system described by Alvarado was designed to reduce negative appendicectomy rate without increasing morbidity and mortality. It is a 10-point scoring system. In his original paper, Alvarado recommended an operation for all patients with score 7 or more. Attempts to increase the diagnostic accuracy in acute appendicitis have included various scoring systems, imaging by ultrasonography and contrast enhanced computed cosmography scan. Ultrasound (US) is often the diagnostic modality of choice in the diagnosis of appendicitis. It lacks ionising radiation, allows dynamic visualisation of the abdominal organs and is of lower cost compared with computed tomography (CT). Many studies indicate a high sensitivity and specificity for US in the diagnosis of appendicitis. An 85–100 % sensitivity and 89–98 % specificity for US accuracy in appendicitis diagnosis have been documented. Ultrasonography avoids the radiation exposure of CT but is not sufficient as the sole diagnostic method in the differentiation of complicated versus uncomplicated AA. Several biomarkers can detect the humoral immune response to AA, but none of them are qualitative enough to be utilized individually. To enhance the diagnostic accuracy of AA without subsequent economic burden, we wanted to focus on the role of traditional biomarkers. Whole blood cell count, especially erythrocyte-related measurements, has raised interest and shown some promise in diagnosing AA. Inflammatory states influence MPV levels, with increases usually found in chronic diseases and decreases seen in acute conditions. The MPV is influenced by cytokines such as interleukin (IL)-1 and IL-6, but variations in platelet indices are more general markers of inflammation than specific markers for AA. The current study was conducted at Mansoura University Hospitals aiming to evaluate MPV as a predictor of acute appendicitis and to compare between MPV and Alvarado score to assess the predictive value. We included a total of 118 patients in the current study. All patients were subjected to complete history taking, clinical examination, and routine laboratory investigations. In addition, the Alvarado score was calculated for all of them, and pelviabdominal US was performed for all patients by an experienced radiologist. All patients underwent appendectomy, and the specimen was sent for histopathological examination, which was taken as a gold standard for the diagnosis. This final diagnosis was correlated with the preoperative Alvarado score, US findings and MPV obtained from the laboratory analysis.