EVALUATION OF THE ASSOCIATION BETWEEN GALL BLADDER WALL THICKNESS AND CRP/ALB RATIO IN THE PATIENTS WITH RIGHT UPPER QUADRANT PAIN

Introduction: Inflammation of gall bladder is a frequently seen gall bladder disease and the determination of the severity of disease requires many parameters. Wall thickness of the gall bladder is one of the first sign of the local inflammation. CRP and albumin are remarkable acute phase reactants to help to understand whether further investigation or treatment is necessary. The aim of the present study was to assess the association between wall thickness of the gall bladder and CRP/Alb ratio in the patients referring due to right upper quadrant pain. Methods: The patients who have referred the department of emergency medicine due to right abdominal quadrant pain and has both hepatobiliary ultrasound (US), computed tomography (CT) were enrolled into the study. Age, gender, referral complaint examination findings (Murphy's sign, right upper quadrant pain) and laboratory analyses (CRP, Alb) of the patients were recorded retrospectively from the hospital record system. Ultrasound and CT findings were existence of biliary stone, pericholecystic fluid and increase in wall thickness of gall bladder (> 3mm). Significance was accepted as p<0.05. Results: The present study was performed with 129 cases including 54 (41.9%) males and 75 (58.1%) females. The age range of the participants was between 18 and 89 and the age average was 48.90 +/- 17.62 years .CRP/Alb ratios of the patients with gall bladder wall thickness over 3 mm in CT scan were significantly higher than those with gall bladder wall thickness of 3 mm and thinner (p=0.001; p<0,01).There is a statistically significant difference detected in CRP/Alb ratios of the patients with gall bladder wall thickness over 3 mm by US (p=0.003; p<0.01). Discussion: Some laboratory parameters may help the physicians when imaging methods such as US and CT do not exist or there are limitations for imaging. Our study showed that elevation of CRP/Alb is significantly associated with increase in wall thickness of the gall bladder. We believe that these parameters may be functional in the algorithms of diagnosis and treatment.