Title : Serum bilirubin level as a laboratory marker in acute appendicitis
Abstract:
Background: Acute appendicitis is the most common acute abdominal condition. For many decades, the diagnosis has depended mainly on clinical examinations, laboratory investigations such as leukocytosis, and abdominal sonography. Occasionally it can be challenging to reach the diagnosis, as there many differential diagnoses for right iliac fossa pains, especially in women. Thus, there is an encouraging demand for laboratory markers for the diagnosis.
Objective: Our study aims to the assessment of total serum bilirubin level as a laboratory marker for diagnosing acute appendicitis.
Methods: A prospective study collected data from 500 patients. All patients' demographic details, duration of symptoms, vital data, and blood samples collected on admission for full blood count, and liver function tests including bilirubin. All the removed appendices will be sent for histopathological examination and were classified into 5 groups according to the histological diagnosis, variable from no pathological findings in the First group, to acute necrotizing appendicitis in the fifth group.
Results: There were major differences between each group as regards the duration of symptoms in hours until the time of taking the samples. There was no difference between the patients regarding the temperature, and the pulse rate, but Total serum bilirubin (TSB) was ≥1.00 (mg/dl), with a sensitivity of 58% and specificity of 82%, with a diagnostic accuracy of 70%. White blood cells (WBCs) were≥11 (×103/µL), with a sensitivity of 68% specificity of 66%, and diagnostic accuracy of 67%.
Conclusion: TSB is a valuable indicator of patients having acute appendicitis, with higher specificity than WBCs.
