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Research Paper | General Surgery | India | Volume 12 Issue 1, January 2023

Evaluation of Hyperbilirubinemia as a New Diagnostic Marker for Acute Appendicitis and it's Role in the Prediction of Appendicular Perforation

Dr. Ratla N. Bharat Singh Naik | Dr. Nagasunitha Kumbha | Dr. Adicherla Naveen Kumar | Dr. Vishnu Sree

Abstract: Background: Hyperbilirubinemiain acute approach, serological markers for appendicitis and it?s perforation, additives and strengthening the existing scoring systems, decrease rate of negative appendicectomy, early & non invasive diagnosis of appendicular perforation. Materials and methods: A prospective non - randomized study conducted in Department of General Surgery, Government Siddhartha Medical College, Vijayawada during the period of October 2021 to November 2022. Results: Of the the fifty patients studied 42 were diagnosed to have acute appendicitis and 8 were diagnosed to have appendicular perforation.36 patients (85.7%) of the total patients diagnosed with Acute appendicitis (n=42) were found to have elevated bilirubin levels (> 1.0 mg/dL) while 6 patients (14.2%) had normal bilirubin levels (? 1.0 mg/dL). Similarly, 7 patients (87.5%) of the total patients diagnosed with Appendicular perforation (n=8) were found to have elevated bilirubin levels (> 1.0 mg/dL) while 1 patient (12.5%) had normal bilirubin levels (? 1.0 mg/dL). The mean bilirubin levels in patients diagnosed with Acute appendicitis was 1.45 ?0.65 mg/dL (range, 0.75 ? 2.05 mg/dL) while in patients diagnosed with Appendicular perforation was 1.92?1.16 mg/dL (range, 0.74 ? 3.06 mg/dL). The Sensitivity and Specificity of serum bilirubin as a marker in predicting acute appendicitis and Appendicular perforation was 83.7% and 12.5% respectively. Similarly the Positive predicative value and Negative predicative value for the same is 78.7% and 14.2% respectively. The Odds ratio was calculated to be 0.85. Conclusion: The present study suggests - Serum bilirubin levels appears to be a promising new laboratory marker for diagnosing acute appendicitis, however diagnosis of appendicitis remains essentially still - clinical. Patients with clinical signs and symptoms of appendicitis and with hyper bilirubinemia higherthe normal range should be identified as having a higher probability of Appendicular perforation suggesting, serum bilirubin levels have an adequate predictivepotential for the diagnosis of Appendicular perforation.

Keywords: Hyperbilirubinemia, acute appendicitis, appendicular perforation

Edition: Volume 12 Issue 1, January 2023,

Pages: 545 - 549