Elevated serum bilirubin in acute appendicular perforation as a newer serum marker: a diagnostic validation test

Abstract

Background: Acute appendicitis is the commonest cause of acute surgical abdomen. Appendicectomy is the most frequently performed urgent abdominal operation and is often the first major procedure performed by a surgeon in training. Delay in diagnosis and treatment results in increased rate of perforation, morbidity, mortality and hospital stay.Methods: A prospective study where a total of 100 patients with clinical, radiological and histopathological diagnosis of acute appendicitis or appendicular perforation were studied. The liver function tests were carried out in all the patients.Results: In a study group of 100 patients (74 males and 26 females); 59 cases were acute appendicitis and 41 cases were appendiceal perforation proven histopathological. Out of which 48 cases had elevated serum bilirubin levels i.e., 17 in acute appendicitis group and 31 in appendicular perforation group. The mean serum total bilirubin is 1±0.4 in acute appendicitis cases and 1.9±1.13 in the appendicular perforation cases. Similarly, the sensitivity and specificity of elevated serum bilirubin as a diagnostic marker in appendicular perforation was found to be 75.6% and 71.2% respectively.Conclusions: Elevated serum bilirubin levels appears to be a promising new supplemental diagnostic serum marker in Appendicular Perforation and perhaps be a decision-making investigation.

The effect of acute complicated appendicitis on liver function test

“…Raised serum bilirubin level is diagnostic marker in appendicular perforation and helpful investigation. 11 Neutrophil are more than 75% raised it showed high index of suspicion of acute appendicitis in children 12 to prevent delay in appendectomy. Hyperbilirubinemia was found 100% in gangrenous appendicitis and helpful in immediate decision for appendectomy and it prevents the laparotomy.…”