Abstract
Objectives: Acute appendicitis is one of the most common surgical emergencies. Perforated appendicitis can result in increased morbidity and mortality. Thus, early identification of perforation can reduce the impact on patient and improve outcome. Apart from total white cell count (TWCC), serum total bilirubin (SB) has been shown to indicate perforation in appendicitis. The aim of this study was to assess the usefulness of serum total bilirubin (SB) as the preoperative indicator for perforated appendicitis.
 Materials and Methods: This was a retrospective study of all appendicectomies cases done in Hospital Universiti Sains Malaysia (HUSM) over a one-year period in 2014. Only patients with histopathologically confirmed appendicitis with available liver function tests and total white blood cell count preoperatively were included in the study. These appendicitis cases were further divided into perforated and non-perforated based on histopathological reports obtained.
 Results: A total of 245 patients had appendicectomy done in 2014 between January to December 2014. Out of 110 from these 245 patients met the inclusion and exclusion criteria. SB was significantly higher (p<0.001) in patients with perforated appendix compared to non-perforated.
 Conclusion: In conclusion, this study showed that preoperative SB is a useful laboratory parameter for perforated appendicitis to improve clinical decision-making by the clinician.
 Bangladesh Journal of Medical Science Vol.18(2) 2019 p.233-237
Highlights
Acute appendicitis is one of the most common acute surgical conditions that require urgent management of emergency surgery[1]
Investigation supported by raised inflammatory or biochemical markers such as C-reactive protein (CRP) and total white cell count (TWCC) are currently being used for the management of acute appendicitis especially in identifying perforated appendicitis
Materials And Methods This was a retrospective study of all appendicectomies done in Hospital Universiti Sains Malaysia (HUSM) between January to December 2014.Patients were identified from the laboratory information system (LIS) of histopathological reports for those who underwent an appendicectomy
Summary
Acute appendicitis is one of the most common acute surgical conditions that require urgent management of emergency surgery[1]. Investigation supported by raised inflammatory or biochemical markers such as C-reactive protein (CRP) and total white cell count (TWCC) are currently being used for the management of acute appendicitis especially in identifying perforated appendicitis. Apart from CRP and TWCC, many studies have shown that hyperbilirubinemia could be used as an indicator of perforation in appendicitis[4,5,6]. Patients with histopathological confirmed appendicitis with available liver function tests and total white blood cell count preoperatively were included in the study. Patients with documented haemolytic or liver disease, history of alcoholism and biliary disease associated with hyperbilirubinemia were excluded These appendicitis cases were further divided into perforated and non-perforated based on the histopathological reports obtained.
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