A STUDY ON HYPERBILIRUBINEMIA IN PATIENTS OF ACUTE APPENDICITIS AND IT'S ROLE IN THE PREDICTION OF APPENDICULAR PERFORATION AT RIMS, RANCHI
Chandra Sahay, Priyanka Priyanka- Ocean Engineering
- Geography, Planning and Development
- General Medicine
Background:Acute appendicitis is 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 with hyperbilirubinemia might have a higher probability of appendicular perforation. Aim: To study the role of elevated serum bilirubin level as a diagnostic marker of acute appendicitis and to evaluate the predictive potential of hyperbilirubinemia in appendicular perforation. Methods: This is an observational prospective study of 100 cases of acute appendicitis with or without appendicular perforation admitted in General Surgery department of Rajendra Institute of Medical Sciences, Ranchi, who underwent appendicectomy for acute appendicitis from August 2019 to October 2021. Results: Most of the patients belonged to the age group of 15-24 years with male to female ratio 1.4:1. Total serum bilirubin levels were raised in 72% patients, comparatively higher in appendicular perforation 77.78% than in acute appendicitis 70.73%. Sensitivity n specicity of hyperbilirubinemia was 70.73% and 22.22% respectively. Conclusion: Serum bilirubin level appears to be a promising new diagnostic laboratory marker which when combined with thorough history taking and clinical examination can aid signicantly to arrive to the diagnosis of acute appendicitis. Higher level of serum bilirubin (≥ 2mg/dl) hints towards the increased chances of appendicular perforation.