Hyperbilirubinemia in Acute Appendicitis as a Predictor of Perforation

Prospective Study Comparing Hyperbilirubinemia, CRP, White Blood Cell Count, and Other Clinical Parameters for the Preoperative Diagnosis of Perforated Acute Appendicitis

It has recently been published that hyperbilirubinemia is a reliable marker for the preoperative diagnosis of perforated acute appendicitis.

The investigators believe, based on their own previous publications, that C-reactive protein (CRP) with or without a white blood cell count and some other clinical parameters, are more specific markers for the preoperative diagnosis of perforated acute appendicitis.

The purpose of this study is to prospectively compare the specificity and sensitivity of hyperbilirubinemia CRP, white blood cell count and other clinical parameters for the preoperative diagnosis of acute appendicitis.

• Previously validated appendicitis score
• Time from onset of symptoms to diagnosis and to surgery
• Laboratory values: WBC, CRP, liver function test
• SIRS values
• Preoperative and postoperative diagnosis
• Length of hospital stay
• Postoperative complications
• Biopsy results

Inclusion Criteria:

• Patients scheduled for appendectomies for acute appendicitis at the emergency unit of our institution
• Patients older than 15 years of age to 100 years of age

Exclusion Criteria:

• Appendectomy performed incidentally or for other indications
• Patients younger than 15 years of age
• Alcoholism
• A history of viral hepatitis
• Gilbert's disease
• Dubin Johnson syndrome
• BRIC (benign recurrent intra-hepatic cholestasis) and other documented biliary
• Hemolytic or liver diseases associated with hyperbilirubinaemia