The Role of Hyperbilirubinaemia as a New Diagnostic Marker for Appendicitis

Chethan Ravindran, Nikhita P, Prajwal P, Lohith AH, Chandan S, Vishwas T

Abstract: Acute appendicitis is the most common surgical emergency and a leading cause of acute abdomen. Delay in surgical intervention can result in complications such as gangrene, perforation, abscess formation, peritonitis, and increased morbidity. While various diagnostic scoring systems exist, they lack the ability to predict complications such as appendicular gangrene or perforation. This study aimed to evaluate the diagnostic and predictive value of elevated total serum bilirubin levels as an indicator of complicated appendicitis. A prospective observational study was conducted over 1.5 years at the Akash Institute of Medical Science and Research Centre, Bangalore. A total of 60 patients aged 18 years and above, diagnosed clinically with acute appendicitis and undergoing emergency appendectomy, were included. Serum bilirubin levels were measured preoperatively and correlated with intraoperative findings and postoperative histopathology, classifying cases into uncomplicated and complicated appendicitis.Out of 60 patients, 49 (81.73%) had acute uncomplicated appendicitis, while 11 (18.26%) had complicated appendicitis (perforation or gangrene). Elevated serum bilirubin levels (>1.0 mg/dL) were observed in 90.4% of patients with complicated appendicitis compared to 31% of those with uncomplicated cases. The sensitivity, specificity, positive predictive value, and negative predictive value of serum bilirubin in predicting complicated appendicitis were 90.4%, 69.14%, 89.58%, and 77.01%, respectively (p < 0.0001). Elevated total serum bilirubin levels serve as a significant, cost-effective, and easily available predictive marker for complicated appendicitis. Incorporating bilirubin measurement in the diagnostic evaluation of suspected appendicitis can aid in early identification of complications, enabling timely surgical intervention and improved outcomes.

Keywords: Acute appendicitis, Serum Bilirubin, Perforated appendix, gangrenous appendicitis, complicated appendicitis

How to Cite?: Chethan Ravindran, Nikhita P, Prajwal P, Lohith AH, Chandan S, Vishwas T, "The Role of Hyperbilirubinaemia as a New Diagnostic Marker for Appendicitis", Volume 14 Issue 7, July 2025, International Journal of Science and Research (IJSR), Pages: 1455-1457, https://www.ijsr.net/getabstract.php?paperid=SR25720174307, DOI: https://dx.doi.org/10.21275/SR25720174307