A Comparative Study of Diagnostic Value of Hyperbilirubnemia in Predicting Appendicitis and Its Complications
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Background: Appendiceal perforation in patients with acute appendicitis may cause a variety of potentially lifethreatening complications. Escherichia coli endotoxin has been shown to impact physiological bile flow in vivo. This had led to the theory that hyperbilirubinemia in patients with appendicitis may have a predictive potential for the preoperative diagnosis of appendiceal perforation. The aim of this retrospective study was to investigate the diagnostic value of hyperbilirubinemia as a preoperative laboratory marker for appendiceal perforation in patients with acute appendicitis Methods: We identified 100patients with histologically proved acute appendicitis who underwent laparoscopic or conventional appendectomy between august 2017 and august 2018 in a surgical department in govt rajaji hospital. A retrospective multiple chart review of the medical records including laboratory values and histologic results was conducted. Results: The mean bilirubin levels in patients diagnosed with acute appendicitis was 1.4 ±0.65 mg/dL (range, 0.75 – 2.05 mg/dL) while in patients diagnosed with Appendicular perforation was 1.9±1.16 mg/dL (range, 0.74 – 3.06 mg/dL). The Direct bilirubin and Indirect bilirubin in patients diagnosed with acute appendicitis was 0.9±0.57 mg/dL and 0.5±0.21 respectively. The Direct bilirubin and Indirect bilirubin in patients diagnosed with Appendicular perforation was 1.2±1.06 mg/dL and 0.70±0.33 mg/dL respectively. 58 patients (71.6%) of the total patients diagnosed with acute appendicitis (n=81) were found to have elevated bilirubin levels while 23 patients (28.4%) had normal bilirubin levels. Similarly, 16 patients (84.21%) of the total patients diagnosed with Appendicular perforation (n=19) were found to have elevated bilirubin levels while 03 patients (15.79%) had normal bilirubin levels. Conclusion: Patients with hyperbilirubinemia and clinical symptoms of appendicitis should be identified as having a higher probability of appendiceal perforation than those with normal bilirubin level
Authors and Affiliations
DR. S. Hemankumar. M. S
Keywords
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- EP ID EP558090
- DOI 10.9790/0853-1803163240.
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