ABSTRACT
Background: Acute appendicitis is the most common cause of acute abdomen in young adults requiring Emergency Surgery. Diagnosing Acute Appendicitis clinically still remains a common surgical problem. Objectives: To study the Incidence of Hyperbilirubinemia in cases of Acute appendicitis and its Complications (Gangrenous/ Perforated), to compare other variables such as age, symptoms, clinical profile, total leukocyte count, Alvarado’s score and USG in a similar role. Materials and methods: All patients presenting with Right Iliac Fossa pain of abdomen who were admitted in the Emergency ward were evaluated by Detailed History and Examination and complete Hemogram, Liver function Test, Seropositivity for Hbs Ag, Alvarado's scoring system and USG. Confirmed cases were operated and clinical diagnosis was confirmed Per-operatively and post operatively by Histopathological Examination. Final HPE was considered as a gold standard for diagnosing and categorising patients as having Normal Appendix, Acute appendicitis and Acute appendicitis with Perforation/ Gangrene. During the study period, out of 249 cases operated, 246 cases were taken for study purpose. Rest of the three cases met the exclusion criteria. Two cases were HbsAg +ve and one case was Acute appendicitis associated with Cholelithisis hence, excluded from the study. Results: Within the 204 cases of Acute suppurative appendicitis, 35 cases had Hyperbilirubinemia (17.16%). Among 42 cases of Gangrenous/ Perforated Appendix, 36 cases had Hyperbilirubinemia (85.71%). Hyperbilirubinemia was most commonly associated with Gangrenous/ Perforated Appendix followed by Acute suppurative appendicitis. Here the cut off value for Hyperbilirubinmia was 1.15 mg and it was supported by statistical analysis. Conclusion: Total serum bilirubin appears to be a new promising marker for diagnosing Gangrenous/ Perforated Appendicitis. Patients with clinical signs and symptoms of Acute appendicitis with raised serum bilirubin should be considered as having high predictive potential for Appendicular gangrene/ Vijayalakshmi S, Jothi Ramalingam S. The role of hyperbilirubinemia as a marker of gangrenous/ perforated appendicitis. IAIM, 2019; 6(6): 100-105. Page 101 Perforation. Serum Bilirubin is an important adjunct in diagnosing the presence of Gangrenous/ Perforated Appendicitis along with other diagnostic aids. Therefore Hyberbilirubinemia may considered as a marker for Gangrenous/ Perforated appendix.