Abstract

Aim: To study the diagnostic role of rise in bilirubin in Acute appendicitis.
Materials and method: Prospective analytical study of Pre-operative Role of Rise in Bilirubin in acute appendicitis was carried out in December 2019 – April 2021. All cases coming with uncomplicated acute appendicitis admitted during study period in Sharda Hospital, Gr. Noida, UP. were included in study. Patients withPre-operative diagnosed case of acute appendicitis with age above 18 years were included. The patients with Complicated appendicitis, Negative proved specimen on Histopathalogy Examination, Patients suffering from Positive HBs Ag, Previous history of Jaundice, Chronic Alcoholism (daily intake of >40 ml for male &>20 ml for female),Patients suffering from Hemolytic Disease, Congenital biliary disease, Hepato-biliary malignancy, Recent history of liver trauma, Cholelithiasis, Females with history of oral contraceptive pill, Patients with history of Statins, Pregnancy were excluded from the study. A detailed history, complete physical examination and routine & appropriate investigations were done for all patients.
Results: The mean age of the study population was 29.46±9.81 (18-70) years with majority of the study population belonging to 18-30 years (62.7%) followed by 31-40 years (22.7%) and above 39 years (14.5%). The study population consisted of 78 (70.9%) males and 32 (29.1%) females. The mean Total Sr. Bilirubin (mg/dL), Direct (mg/dL) and Indirect (mg/dL) among study population was 0.98±0.37 (0.29-2.11), 0.77±0.33 (0.28-1.72) and 0.20±0.21 (0.00-1.73). The mean Alvarado Score of the study population was 7.40±0.59 (7-9). The mean Total Sr. Bilirubin (mg/dL) was significantly more among subjects with Alvarado score≥ 7 compared to subjects with Alvarado score7. Frequency Percent Paracaecal 18 16.4% Pelvic 1 0.9% Retrocaecal 89 80.9% Subcaecal 2 1.8% Total 110 100.0% The Pre-operative findings showed that appendicitis was Paracaecal, among 18 (16.4%), Pelvic, among 1 (0.9%), Retrocaecal, among 89 (80.9%) and Subcaecal, among 2 (1.8%) subjects. There was no significant difference in mean TLC (/mm3) between subjects with Abnormal and Normal Bilirubin level. The mean C-Reactive Protein (mg/dL) was significantly more among subjects with Abnormal Bilirubin level compared to Normal Bilirubin level.