The Diagnostic Role Of Immature Granulocyte In Differentiating Acute Calculous Cholecystitis From Biliary Colic

INTRODUCTION: Acute biliary cholecystitis (ABC) is a significant cause of abdominal pain in emergency department. In this study, we investigated the role of immature granulocytes (Ig) as a marker of the inflammatory response in distinguishing between biliary colic and Acute biliary cholecystitis.
METHODS: This retrospective study was conducted with a total of 150 patients who presented with abdominal pain and were found to have or were diagnosed with gallstones. Patients were divided into two groups as biliary colic and ATK. Laboratory values of the patients such as age, WBC, Hgb, Plt, MPV, RDW, Neu, Lymp, Ig%, Ig Number, and CRP were recorded in the study form. ROC and regression analysis were performed for the diagnosis of Acute biliary cholecystitis.
RESULTS: We found that the values of WBC, Neu, and Ig number were statistically significantly higher in ABC patients than in biliary colic patients. However, in the regression analysis, only the Murphy's sign and CRP value were found to be significant in the diagnosis of Acute biliary cholecystitis (p<0.001, OR: 0.119 (95%CI: 0.053-0.268), p=0.002, OR: 1.007 (95%CI: 1.002-1.011), respectively).
DISCUSSION AND CONCLUSION: Although the Ig number is statistically significant in distinguishing between Acute biliary cholecystitis and biliary colic, we believe that the CRP value and Murphy's sign are superior parameters.