White blood cell counts an patients undergoing abdominal surgery

Background: The role of pre-operative white blood cell counts (WBCC) in patients with an acute abdomen is contentious. Methods: This study documents the association between pre-operative WBCC and the extent of intraperitoneal inflammation at the time of surgery in a heterogeneous group of 1166 patients undergoing abdominal surgery. Results: WBCC failed to adequately discriminate between groups of patients with varying degrees of intraperitoneal inflammation. For example, only 31% (37/118) of the patients with either free pus or an abscess within the peritoneal cavity had a WBCC > 15.0 x 10(9)/L. Conclusions: There is a need to replace the WBCC with more powerful predictors of inflammation within the peritoneal cavity.