Evaluation of hyperbilirubinaemia as a new diagnostic marker for acute appendicitis & its role in prediction of appendicular perforation
Journal Title: Surgical Update: International Journal of Surgery and Orthopedics - Year 2016, Vol 2, Issue 4
Abstract
Introduction: Acute appendicitis is the most common general surgical emergency and early surgical intervention improves outcomes. The diagnosis of appendicitis can be elusive, and a high index of suspicion is important in preventing serious complications from this disease. The present study was undertaken to assess relationship between hyperbilirubinemia and acute appendicitis to evaluate its credibility as a diagnostic marker for acute appendicitis. Material & methods: The case control study was carried out on 60 patients who were clinically diagnosed as having acute/perforated appendicitis and on 60 healthy volunteers from the community having no signs and symptoms of acute appendicitis. The evaluation of acute appendicitis was done by history taking ,clinical examination and investigations including CBC, Ultrasonography and confirmed by histopathological examination of appendicectomy specimen. For the final analysis various statistical methods like descriptive, crosstabs, chi-square test were applied using the SPSS (version 20.0). Results: Total serum bilirubin level was raised in 43 patients (71.7%) out of the total sample of 60 cases. Of these, 42(70%) cases were positive for appendicitis on HPE (True Positive), and 1(1.7%) was negative on HPE (false positive). Among the 17(28.3%) cases in whom serum bilirubin was not raised, in 3(5%) cases HPE was negative (True Negative), and in 14 (23.3%) cases HPE was positive (False Negative). In 60 healthy individuals mean serum bilirubin was 0.7±0.3 mg%. In 46 cases of histopathologically proved acute appendicitis (non-perforated) the mean serum bilirubin was 1.3±7mg% while in perforated group it was 2.5±1.1mg% (P value was significant i.e. <0.001). Conclusion: Serum bilirubin is an important adjunct in diagnosing the presence of gangrenous/perforated appendicitis. Our findings confirm that hyperbilirubinaemia has a high specificity for distinguishing acute appendicitis.
Authors and Affiliations
U K Chandel, Dhruv Sharma, Surinder Surinder, Prikshit Malhotra
Keywords
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- EP ID EP227344
- DOI 10.17511
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