HYPERBILIRUBINEMIA MIGHT BE A MARKER OF GANGRENOUS/PERFORATED APPENDICITIS: A RETROSPECTIVE STUDY
- VernacularTitle:ИЙЛДЭС ДЭХ БИЛИРУБИН ИХСЭХ НЬ МУХАР ОЛГОЙН ҮХЖСЭН/ЦООРСОН ҮРЭВСЛИЙН ШАЛГУУР БОЛОХ НЬ
- Author:
Buyantugs Ts
;
Taivanbat J
;
Nasanbat G
;
Orgil N
;
Erkegul B
;
Odonchimeg B
;
Bayarsaikhan B
;
Davaadorj N
;
Lkhagvabayar B
- Collective Name:Ulaanbaatar Songdo Hospital
- Publication Type:Journal Article
- Keywords:
Acute appendicitis;
gangrenous/perforated appendicitis;
hyperbilirubinemia
- From:Journal of Surgery
2016;20(2):18-24
- CountryMongolia
- Language:Mongolian
-
Abstract:
Introduction: Delayed or wrong diagnosis
in patients with appendicitis can result in
perforation and consequently increased
morbidity and mortality. Serum total bilirubin
may be a useful marker for appendiceal
perforation. The aim of this study was
to determine and compare pre-operative
total bilirubin level and other diagnostic
tools (patient age, duration of symptoms,
Alvarado score, white blood cell, C-reactive
protein, ultrasound and contrast enchanced
CT scan) in cases of acute appendicitis in
order to improve the clinical decision making.
Materialsand methods: We identified
102 patient with acute appendicitis after
excluding those with other causes of
hyperbilirubinemia among the 180 patients
that underwent a laparoscopic or an open
appendectomy from June, 2011 to March,
2015 in UB Songdo Private Hospital.
These cases were also subjected to
liver function tests and clinical diagnosis
was confirmed perioperatively and postoperatively
by histopathological examination.
According to histological results, these cases
were classified two groups: positive(acute
appendicitis with perforation and/or
gangrene) and negative(acute appendicitis
without perforation or gangrene). Their
clinical and investigative data were compiled
and analyzed. Statistical analysis was
performed using independent sample t test,
Chi square test, and direct logistic regression.
The level of significance was set at P< 0.05.
Results: Serum total bilirubin was found
to be significantly increased(1,5mg/dL) in
case of negative group and much higher
(3,6mg/dL) in cases of positive group (P
<0.001). The level of total bilirubin was
higher than 3 mg/dL in cases of gangrenous/
perforated appendicitis while in cases with
acute appendicitis it was lower than 3 mg/
dL. Also Alvarado score (P <0.01), C-reactive
protein (P <0.001) and contrast enchanced CT
scan (P <0.05) were statistically significant
diagnostic tools for acute appendicitis.
Conclusion: Assessment of preoperative
total bilirubin is useful for the differential
diagnosis of gangrenous/perforated
appendicitis.
- Full text:W020170329604459609431.pdf
