Background: Acute appendicitis being the most common condition that needs urgent intervention, has to be diagnosed and evaluated at the earliest. It is found that a correlation exists between appendicular perforation and high serum bilirubin level. In the absence of radiological investigations, patients with clinical signs and symptoms of appendicitis and with hyperbilirubinemia might have a higher probability of appendicular perforation.
Method: This is a prospective study of patients admitted in ESI PGIMSR & Model Hospital, Basaidarpur,
New Delhi, who underwent appendectomy for acute appendicitis from October 2016 to January 2018. A study population of 100 cases with the diagnosis of acute appendicitis with or without appendicular perforation were selected.
Results: In our study, appendicular perforation patients had significant increase in serum bilirubin. 27 % of patients with appendicitis had elevated bilirubin level, where as in perforated appendicitis patients 93 % of the patients had elevated bilirubin level, this difference was statistically found to be significant (P<0.001). The serum bilirubin as a predictor for appendicular perforation revealed Sensitivity of 93.3%, Specificity of 72.3%, with the Positive Predictive value 37.8%, Negative Predictive value 98.4%.
Conclusion: The present study suggests that serum bilirubin level estimation, a simple cheap and easily available test in every laboratory, can be added to the routine investigation list of clinically suspected case of acute appendicitis or perforated appendix for the confirmation of diagnosis.
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