Role of hyperbilirubinemia as a diagnostic marker for acute appendicitis : a hospital based study from Tamil Nādu

Type of artical: Original Research Article

Background & objectives: The rise of bilirubin levels can enhance the precision of clinical diagnosis for acute appendicitis and, significantly, aid in the anticipation and prevention of potential complications associated with this condition. The aim of this study was to examine the correlation between hyperbilirubinemia and acute appendicitis, and to assess its validity as a diagnostic indicator for acute appendicitis. Methods: A total of one hundred patients, exhibiting symptoms of right iliac fossa pain that clinically indicate appendicitis or appendicular perforation, and falling within the age range of 21 to 50 years, were included in the study using successive sampling. Routine laboratory examinations were conducted in all individuals. The measurement of serum bilirubin levels was conducted in all patients using a fully automated analyser system. Results: The levels of total bilirubin (mg/dl) were 0.90±0.34 mg/dl in simple cases, 2.15±0.83 mg/dl in cases of perforated appendicitis, and 2.47±1.23 mg/dl in cases of perforated appendicitis. Among a total of 85 instances, 26 cases exhibited a bilirubin level over 1mg/dl. Furthermore, in the subset of gangrenous appendicitis cases (n=3), all cases demonstrated a bilirubin level exceeding 1mg/dl. Similarly, among the 12 cases of perforated appendicitis, 11 cases exhibited a bilirubin level exceeding 1mg/dl. Conclusions: The presence of elevated total serum bilirubin levels in the absence of elevated liver enzymes serves as a reliable signal for appendicular perforation. The measurement of total serum bilirubin shows potential as a novel and effective laboratory indicator for the diagnosis of appendicular perforation.