Role of serum bilirubin in predicting the severity of acute appendicitis

Dr. Marshall Daud Kerketta; Dr. Aravind. K. R.; Dr. Gajendra Pandit; Dr. Makbul Ansari; Dr. Suman Kumar

Volume : IX, Issue : IV, April - 2020

Role of serum bilirubin in predicting the severity of acute appendicitis

Dr. Marshall Daud Kerketta, Dr. Aravind. K. R. , Dr. Gajendra Pandit, Dr. Makbul Ansari, Dr. Suman Kumar

Abstract :

Background: The aim of the study was to establish the role of hyperbilirubinemia as a new diagnostic tool to predict gangrenous/perforated appendicitis. Methods: A prospective study carried for 18 months (Jan 2018 to June 2019) at Rajendra institute of medical sciences, Ranchi, Jharkhand. All patients admitted with clinical diagnosis of acute appendicitis and posted for surgery were included in the study. Serum total bilirubin results will be compared with Rajendra institute of medical sciences, Ranchi, Jharkhand. These cases will be operated and clinical diagnosis will be confirmed per- operatively and post-operatively by histopathological examination. Final histopathological examination will be considered as a gold standard for diagnosing and categorizing patients as having normal appendix, acute appendicitis and acute appendicitis with perforation and/or gangrene. Based on histopathological examination patients will be categorized as positive (acute appendicitis with perforation and/or gangrene) and negative (acute appendicitis without perforation or gangrene). Results: Sensitivity of serum bilirubin in case of perforated/gangrenous appendicitis was found to be 90%. Specificity of serum bilirubin was found in case of perforated/gangrenous appendicitis was found to be 90.47%. Positive predictive value and negative predicting value of serum bilirubin in perforated/gangrenous appendicitis was found to be 81.8% and 95% respectively with p value of 0.003. Conclusions: Serum total bilirubin is an easily available and cheap and can be estimated from the same blood sample withdrawn for routine investigations, if added to routine investigations, then diagnosis of complicated appendicitis can be made with fair degree of accuracy.