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Faruk Hassan Faraj *, Sherko Abdullah Molah Karim * and Fattah Hama Rahim Fattah ***

*    Department of Surgery, School of Medicine, Faculty of Medical Sciences, University of Sulaimani.
**  Ranya General Hospital.
*** Department of Community Medicine, School of Medicine, Faculty of Medical Sciences, University of Sulaimani.

Submitted: 18/10/2014; Accepted: 6/1/2015; Published 1/12/2015



Acute appendicitis is one of the most common causes of acute abdomen. Its accurate diagnosis and immediate surgery are important, because the disease itself and its operation carry a potential risk of morbidity and mortality. The aim of this study is to detect the role of Neutrophil/Lymphocyte Ratio in diagnosis of acuteappendicitis and detection of the severity of the inflammation.


The relation between the values of NLR and positive appendectomy and normal appendectomy. The relation between Neutrophil Lymphocyte Ratio and the degree of severity of inflammation in acute appendicitis.


This prospective study was performed in Emergency Hospital of Slemani from February, 25th, 2012 to November, 29th, 2012 on 200 patients who were admitted with clinical suspicion of acute appendicitis. Data were collected regarding demographical aspects of patients, presentations, pre operative care, investigations including complete blood counts, histopathological examination of the all specimens after surgery.


There were 78(39%) males and 122 females (61%). Male: female ratio was 1:1.25. The age ranges from 5 to 67 years. The mean age of acute appendicitis was 25.94±12.4. Histopathological examination revealed normal appendix in 74 patients. The normal appendectomy rate was (36.7%). The rate of normal appendectomy in
females was (43.3%), while among males it was (26.9%). In (85%) of patients with acute appendicitis there were elevated Neutrophil Lymphocyte Ratio (NLR) ≥ 3.5 with specificity of (72%), and accuracy of (80%), and Neutrophil Lymphocyte Ratio was increased with increasing the degree of inflammation.


The Neutrophil Lymphocyte Ratio is an easy and applicable investigation which can be helpful in diagnosis of acute appendicitis, and detecting the severity of the inflammation.


Acute Appendicitis, Neutrophil/Lymphocyte Ratio.


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