HYPERBILIRUBINAEMIA IN ACUTE APPENDICITIS AND ITS ROLE IN PREDICTING COMPLICATIONS, PARTICULARLY APPENDICULAR PERFORATION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 76
Abstract
BACKGROUND Appendicitis is a disease of young adults with 40% of cases occurring in patients between the ages of 10 and 29 years. Appendectomy is the most commonly performed urgent abdominal surgery. This study aims at revealing hyperbilirubinaemia as a laboratory marker for diagnosing the severity of acute appendicitis based on correlation between hyperbilirubinaemia and intra-operative findings in patients undergoing emergency appendectomy for acute appendicitis. MATERIALS AND METHODS This descriptive study reviewed the correlation of hyperbilirubinaemia and acute appendicitis and its complications among the 237 patients who had undergone open or laparoscopic appendectomy (after excluding patients with other causes of hyperbilirubinaemia) in our institution from January 2015 to July 2017. A retrospective chart review of medical records, lab investigations and intraoperative findings were recorded and the data was analysed. RESULTS Among 237 patients who had undergone emergency open or laparoscopic appendectomy during this interval, hyperbilirubinaemia was found in 89 patients (37.55%). Among these 72 patients (80.90%) had perforated or gangrenous appendix, whereas appendix was found to be inflamed in 17 patients (19.10%). Normal levels of serum bilirubin was found in 148 patients (62.44%), out of which 32 patients (21.62%) had perforated appendix and remaining 116 patients (78.38%) had inflamed appendix. CONCLUSION In our study hyperbilirubinaemia was found in 12.78% of patients with acute appendicitis without any complication, whereas hyperbilirubinaemia was seen in 69.23% of patients with acute appendicitis with perforation/gangrene. Thus, serum bilirubin can be used as an adjunct laboratory tool for diagnosing the severity of acute appendicitis.
Authors and Affiliations
Atul Mahajan, Anupam Nanda, Neeraj Sharma, Rohit Thakur, Rajat Kaundal, Raman Deep, Payal Kumari, Shalina Bhardwaj
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