Diagnostic accuracy of hyperbilirubinemia in preoperative diagnosis of acute perforated appendix

Abstract

Background: Delayed diagnosis of perforated appendicitis is a life threating condition. All these cases warrant expeditious surgical intervention. Hyperbilirubinemia can play a vital role in early diagnosis of perforated appendix and thereby reduce mortality, morbidity and prolonged hospital stay. The aim of this study is to compare the levels of bilirubin in simple appendicitis and perforated appendicitis.Methods: This was a single center retrospective study of 100 patients who attended Surgery OPD with right iliac fossa pain during the period between July 2017 and June 2018.Results: During the period of study, 100 patients were selected of which 18 (18%) subjects were diagnosed having perforated appendix and 82 (82%) cases were having non-perforated appendix. The mean serum bilirubin levels were 1.65±0.83 among subjects diagnosed having perforated appendix whereas it was 0.82±0.36 among subjects having non-perforated appendix. Further raised levels of bilirubin levels in blood were detected among 20 cases, of which 17 cases were diagnosed having perforated appendix. Out of total 20 cases in whom hyperbilirubinemia was observed, only 3 cases were having non-perforated appendix. Of total 80 cases in which normal Bilirubin levels in blood were detected, only 1 case had perforated appendix.Conclusions: Preoperative serum bilirubin levels are promising tool with high diagnostic accuracy in preoperative diagnosis of acute perforated appendix when used together with clinical correlation.