Evaluation of Serum Bilirubin as a Predictive Marker for Simple and Complicated Appendicitis in Sulaimani Emergency Teaching Hospital
Diagnosis of acute appendicitis can be challenging in some cases as the differentials can be exhaustive. Previous studies have demonstrated that hyperbilirubinemia is a more specific marker for appendicitis than white blood count (WBC) and C-reactive protein (CRP), but this investigation is still no...
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| Format: | Article |
| Language: | English |
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Sulaimani Polytechnic University
2018-07-01
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| Series: | Kurdistan Journal of Applied Research |
| Subjects: | |
| Online Access: | https://www.kjar.spu.edu.iq/index.php/kjar/article/view/190 |
| _version_ | 1797193716893483008 |
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| author | Seerwan Hama Shareef Dara Ahmed Mohammed Goran Ameer Ahmed |
| author_facet | Seerwan Hama Shareef Dara Ahmed Mohammed Goran Ameer Ahmed |
| author_sort | Seerwan Hama Shareef |
| collection | DOAJ |
| description | Diagnosis of acute appendicitis can be challenging in some cases as the differentials can be exhaustive. Previous studies have demonstrated that hyperbilirubinemia is a more specific marker for appendicitis than white blood count (WBC) and C-reactive protein (CRP), but this investigation is still not commonly used in the diagnostic workup of appendicitis. This prospective study aims to evaluate serum bilirubin as a laboratory marker for simple and complicated appendicitis. We also investigated the diagnostic value of bilirubin in acute appendicitis and compared it with the WBC. In this prospective study, all patients who underwent appendicectomy at the Sulaimani Emergency Teaching Hospital between 1st November 2016 to 1st January 2017 were included. Preoperative total serum bilirubin was measured and compared with the final histopathology report. Patients were divided into 3 groups: non-inflamed appendix, simple appendicitis and complicated appendicitis. One hundred and 75 patients were analysed, 90 of them were females and 85 were males. Hyperbilirubinemia was found in 63% of patients with complicated appendicitis (p=0.001). Mean of bilirubin was significantly different between patients with complicated appendicitis and non-complicated appendicitis (1.101 vs 0.75 mg/dl; p= 0.0017). Bilirubin had a higher specificity (85%) than WBC (36%), but a lower sensitivity (63% vs 89%) for differentiating complicated appendicitis. Patients with suggestive features of acute appendicitis and raised serum bilirubin indicate a complicated case requiring early intervention to prevent peritonitis and septicaemia. Hyperbilirubinemia is a good indicator for complicated appendicitis and serum bilirubin measurement can be included in the work up of patients with suspected appendicitis.
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| first_indexed | 2024-03-07T15:25:47Z |
| format | Article |
| id | doaj.art-797f616aedc24d74b8f386576961e2cf |
| institution | Directory Open Access Journal |
| issn | 2411-7684 2411-7706 |
| language | English |
| last_indexed | 2024-04-24T05:44:49Z |
| publishDate | 2018-07-01 |
| publisher | Sulaimani Polytechnic University |
| record_format | Article |
| series | Kurdistan Journal of Applied Research |
| spelling | doaj.art-797f616aedc24d74b8f386576961e2cf2024-04-23T17:21:17ZengSulaimani Polytechnic UniversityKurdistan Journal of Applied Research2411-76842411-77062018-07-013210.24017/science.2018.2.3Evaluation of Serum Bilirubin as a Predictive Marker for Simple and Complicated Appendicitis in Sulaimani Emergency Teaching HospitalSeerwan Hama Shareef0Dara Ahmed Mohammed1Goran Ameer Ahmed2Department of General Surgery, College of Medicine, University of Sulaimania, Sulaimania, IraqDepartment of Anatomy, College of Medicine, University of Sulaimania, Sulaimania, IraqDepartment of General surgery, College of Medicine, University of Sulaimania, Sulaimania ,IraqDiagnosis of acute appendicitis can be challenging in some cases as the differentials can be exhaustive. Previous studies have demonstrated that hyperbilirubinemia is a more specific marker for appendicitis than white blood count (WBC) and C-reactive protein (CRP), but this investigation is still not commonly used in the diagnostic workup of appendicitis. This prospective study aims to evaluate serum bilirubin as a laboratory marker for simple and complicated appendicitis. We also investigated the diagnostic value of bilirubin in acute appendicitis and compared it with the WBC. In this prospective study, all patients who underwent appendicectomy at the Sulaimani Emergency Teaching Hospital between 1st November 2016 to 1st January 2017 were included. Preoperative total serum bilirubin was measured and compared with the final histopathology report. Patients were divided into 3 groups: non-inflamed appendix, simple appendicitis and complicated appendicitis. One hundred and 75 patients were analysed, 90 of them were females and 85 were males. Hyperbilirubinemia was found in 63% of patients with complicated appendicitis (p=0.001). Mean of bilirubin was significantly different between patients with complicated appendicitis and non-complicated appendicitis (1.101 vs 0.75 mg/dl; p= 0.0017). Bilirubin had a higher specificity (85%) than WBC (36%), but a lower sensitivity (63% vs 89%) for differentiating complicated appendicitis. Patients with suggestive features of acute appendicitis and raised serum bilirubin indicate a complicated case requiring early intervention to prevent peritonitis and septicaemia. Hyperbilirubinemia is a good indicator for complicated appendicitis and serum bilirubin measurement can be included in the work up of patients with suspected appendicitis. https://www.kjar.spu.edu.iq/index.php/kjar/article/view/190Acute appendicitis, Appendectomy, Hyperbilirubinaemia, Diagnostic markers. |
| spellingShingle | Seerwan Hama Shareef Dara Ahmed Mohammed Goran Ameer Ahmed Evaluation of Serum Bilirubin as a Predictive Marker for Simple and Complicated Appendicitis in Sulaimani Emergency Teaching Hospital Kurdistan Journal of Applied Research Acute appendicitis, Appendectomy, Hyperbilirubinaemia, Diagnostic markers. |
| title | Evaluation of Serum Bilirubin as a Predictive Marker for Simple and Complicated Appendicitis in Sulaimani Emergency Teaching Hospital |
| title_full | Evaluation of Serum Bilirubin as a Predictive Marker for Simple and Complicated Appendicitis in Sulaimani Emergency Teaching Hospital |
| title_fullStr | Evaluation of Serum Bilirubin as a Predictive Marker for Simple and Complicated Appendicitis in Sulaimani Emergency Teaching Hospital |
| title_full_unstemmed | Evaluation of Serum Bilirubin as a Predictive Marker for Simple and Complicated Appendicitis in Sulaimani Emergency Teaching Hospital |
| title_short | Evaluation of Serum Bilirubin as a Predictive Marker for Simple and Complicated Appendicitis in Sulaimani Emergency Teaching Hospital |
| title_sort | evaluation of serum bilirubin as a predictive marker for simple and complicated appendicitis in sulaimani emergency teaching hospital |
| topic | Acute appendicitis, Appendectomy, Hyperbilirubinaemia, Diagnostic markers. |
| url | https://www.kjar.spu.edu.iq/index.php/kjar/article/view/190 |
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