A Prospective Observational Study to Assess Role of Isolated Hyperbilirubinemia to Predict Gangrenous/Perforated Appendicitis

Abstract

Aim:Theaimof studywas toassess theroleofhyperbilirubinemiaasapredictorofgangrenousorperforated appendicitis. Introduction: Appendicitis is characterised by means of infection and inflammation of the appendix. It was hypothesized that an association exists between the presence of appendiceal perforation and hyperbilirubinemia.The present study has been designed to evaluate the association between hyperbilirubinemia in cases of acute appendicitis and its complications. Methods: This study was conducted at SMS hospital Jaipur as a prospective observational study. One hundred twenty patients of appendicitis were enrolled from 1 March 2017 to 30 November 2018 according sample size. Patients underwent appendectomy after confirmation of diagnosis by USG and other investigations and biopsy was sent for histopathological examination. Results: Total 120 patients were analysed In our study as per inclusion criteria. Hyperbilirubinemia (>1.2 mg/dL) was found in gangrenous appendicitis and perforated appendicitis (91.67% and 100% respectively) as compared to in acute appendicitis (15.63%) cases (P<0.001). most of the acute (84.37%) and some gangrenous appendicitis (8.33%) patients had normal TSB but all perforated appendicitis patients had hyperbilirubinemia (>1.2 mg/dL). Liver enzymes were normal in most of cases or slightly elevated in some cases.Alvarado Score and CRP were also significantly elevated in complicated appendicitis than acute appendicitis. Conclusion: Our study concluded that isolated hyperbilirubinemia is a predictor of perforated or gangrenous appendicitis.High Alvarado Score and CRP level are also indicating complicated appendicitis.