Hyperbilirubinemia as a predictive factor in acute appendicitis

Eren, Tunç; Tombalak, Ercüment; Özemir, İbrahim Ali; Leblebici, Metin; Ziyade, Sedat; Ekinci, Özgür; Ali̇moğlu, Orhan

doi:10.1007/s00068-015-0562-4

Cited by 29 publications

(34 citation statements)

References 24 publications

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“…While Emmanuel et al In his study Regarding histopathological reports 386 patients (82%) had an inflamed appendix and 86 patient (18%) had normal appendix [8]. in Eren et al study Histopathological examinations revealed inflamed appendix in 141 (87%) patients and twentyone patients (13%) had normal appendix [9]. So removal of normal appendix still has significant incidence in our study and other studies.…”

Section: Discussionsupporting

confidence: 49%

“…tis), thirty-eight patients (40.5%) had acute suppurative appendicitis and seven patients (7.4%) had gangrenous appendicitis, and thirteen patients (13.8%) had normal appendix. While Eren et al in his study Histopathological examinations revealed normal appendix in twenty-one (13%) patients, non-complicated acute appendicitis in one-hundred (62%), and appendicular gangrene/perforation in forty-one (25%) patients [9]. Estrada et al in his study 116 patients (68%) had evidence of acute suppurative appendicitis, and forty-one patients (24%) had gangrenous/perforated appendicitis on final histopathological analysis, and thirteen patients (8%) had normal appendix [10].…”

Section: Discussionmentioning

confidence: 82%

“…In Eren et al study found that Total and direct bilirubin levels were also significantly elevated in patients with acute and gangrenous/perforated appendicitis (p < 0.01). According to multivariate analysis, elevated total bilirubin levels were associated with five times, and elevated direct bilirubin levels were associated with 36 times greater risk for appendicular gangrene/perforation [9]. Moreover, in Emmanuel et al study The mean bilirubin levels were higher for patients with simple acute appendicitis compared to those with a non-inflamed appendix, and significantly more patients in this group had hyperbilirubinemia on admission (30% vs 12%, p<0.001).…”

Section: Discussionmentioning

confidence: 89%

“…While in Emmanuel et al In his study including 472 patients, 254 patients (53.8%) were male and (46.2%) female and the mean age was (27) years [8]. While in Eren et al study group of 162 patients consisted of 97 (60%) men and 65 (40%) women with a median age of 36 years [9]. So our study differed from another study as female more than males due to female have more other causes of a right iliac pain than males and this the cause that removal of normal appendix more in female patients.…”

Section: Discussionmentioning

confidence: 93%

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Validity of Serum Total Bilirubin as a Diagnostic Tool for Acute Appendicitis

Abouzeid¹,

Saleh²,

Zayed³

et al. 2017

Int J Surg Med

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Background: Acute appendicitis occurs through bacterial invasion in appendix leads to transmigration of bacteria and release of tumour necrosis factor (TNF)-alpha, Interleukin-6 (IL6) and cytokines. These reach the liver through a superior mesenteric vein and may produce inflammation or dysfunction of liver either directly or indirectly by altering hepatic blood flow with rising of total serum bilirubin. Objective: To evaluate the validity of elevated serum total bilirubin as a diagnostic marker for acute appendicitis and if elevated serum total bilirubin levels have a predictive potential for the diagnosis of complicated appendicitis. Methods: This is a prospective cross-section study including ninety-four (94) of adult patients have right iliac fossa pain attending to the Emergency Department (ED) at Suez Canal University Hospital. All 94 patients undergo total serum bilirubin measuring and postoperative histopathological examination of the removed appendix. Results: Amongst the patients diagnosed with acute appendicitis post-operatively, 57 patients (70.4%) were found to have elevated serum total bilirubin (>1.2mg/dL) while 24 patients (29.6%) had normal serum total bilirubin levels (≤ 1.2 mg/dL). Conclusion: Serum total bilirubin level appears to be a promising new laboratory marker for diagnosing acute appendicitis and have a predictive potential for the diagnosis of complicated appendicitis.

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 93%

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Validity of Serum Total Bilirubin as a Diagnostic Tool for Acute Appendicitis

Abouzeid¹,

Saleh²,

Zayed³

et al. 2017

Int J Surg Med

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“…24 According to a similar study done by Eren T et al raised bilirubin was seen in 10% cases with simple appendicitis and 59% with perforated/ gangrenous one. 25 According to a study done by Cheekuri et al, they compared the three groups i.e. normal cases, acute appendicitis and the cases with perforated/ gangrenous appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of total leucocyte count (TLC), bilirubin and C-reactive protein in the diagnosis of gangrenous and perforated appendicitis.

Iqbal

Ahmad

Saeed

et al. 2019

TPMJ

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Acute appendicitis is the most common cause of acute abdomen. Most of the cases are diagnosed on history, clinical examination and raised TLC but gangrenous and perforated appendicitis are difficult to diagnose. The TLC, Serum bilirubin and C-reactive protein (CRP) have been shown to indicate perforation in appendicitis. Objectives: The purpose of this study was to evaluate the role of TLC, hyperbilirubinemia and CRP in the diagnosis of perforated appendix and surgery should be planned. Material & Methods: This study consisted of patients admitted with the clinical suspicion of acute appendicitis. ALVARADO score was calculated. 120 patients with ALVARADO score more than 6 and histologically diagnosed appendicitis were finally included in the study. A proforma was filled which included patients name, age, sex, duration of pain, TLC count, C-Reactive protein (CRP) level and serum total bilirubin level and diagnosis of appendicitis (acute appendicitis, gangrenous appendicitis and perforated appendicitis. Patients were divided into 3 groups. Group A comprised of patients with features of simple appendicitis (AA), Group B Gangrenous appendicitis (GA) and group C Perforated appendicitis (PA). Results: There were 81 patients of acute appendicitis, 13 patients of gangrenous appendicitis and 26 patients of perforated appendicitis. TLC was raised in 13 patients of AA, 10 patients of gangrenous appendicitis and 24 patients of perforated appendicitis. Hyperbillirubinemia (>1mg/dl) was present in 9 patients of GA and 20 patients of PA. Raised C-Reactive protein level (>5mg) was present in 10 patients of GA and 21 patients of PA. There was significant correlation of raised TLC, hyperbillirubinemia and C-reactive protein in gangrenous and perforated appendicitis and p value was less than 0.05. Predictive value of bilirubin in GA and PA was 56.25 % and 74.04 %respectively. Predictive value of C Reactive Protein in GA and PA was 41.66 and 60 respectively. Predictive value of TLC in GA and PA was 43.47 and 60.86 respectively. Conclusion: All the patients who present with pain in right iliac fossa, lower abdominal tenderness and rigidity, Alvarado score>7, raised TLC, CRP and hybillirubinemia are the suspected case of perforated appendix and should be aggressively resuscitated and operated.

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