A prospective study of 70 cases evaluating the role of hyperbilirubinemia in acute inflammation of appendix

Abstract

Acute Appendicitis is the most common general surgical emergency, and early surgical intervention improves outcomes. Despite the increased use of ultrasonography, computed tomography scanning and laparoscopy, the rate of misdiagnosis of appendicitis has remained constant (15.3%), as has the rate of appendiceal perforation.In an age accustomed to early and accurate preoperative diagnosis, acute appendicitis remains an enigmatic challenge and a reminder of the art of surgical diagnosis. Aim: To evaluate the role of hyperbilirubinemia in Appendicitis Material and methods: A prospective study of 70 clinically suspected cases of appendicitis admitted in surgical unit-6, Lata mangeshkar hospital, Nagpur were subjected to investigations to confirm the diagnosis from April 2011- April 2012. Data collected included total leucocyte count, liver function test and ultrasound. Subsequently these cases were operated and clinical diagnosis was confirmed by histopathology. Results: Out of 70 cases, 41 were males and 29 were females. Their age ranged from 12 years to 60 years with average of 26.9 years. Duration of symptoms ranged from 1 day to maximum 8 days. All the cases diagnosed as acute appendicitis clinically. Per operatively, all cases had inflamed appendix. Among 70 cases, SB was raised in 42 (60%) cases where as 28 (40%) cases had normal SB level. It ranged from 1.2 mg/dL to 4.0 mg/dL. The average level of SB was 1.648 mg/dL. Conclusion: Our study concludes that there was hyperbilirubinemia in 60% of the patients of acute appendicitis. Elevated serum bilirubin ranged from 1.2mg/dL - 4 mg/dL and was of mixed type. When compared to other studies there was no complicated appendicitis encountered in our study.