Abstract

Context: The risk of perforation and necrosis is elevated by delayed diagnosis of acute appendicitis, which is the most prevalent surgical emergency. The clinical relevance of identifying a simple biochemical marker for the early detection of complicated appendicitis remains intact. Aims: To study the relationship between hyperbilirubinemia and acute appendicitis and to evaluate its usefulness as a diagnostic marker for complicated appendicitis, and to differentiate appendicitis from other causes of right iliac fossa pain. Settings and Design: A prospective observational study was conducted at a tertiary care teaching hospital in India. Methods and Material: One hundred twenty patients with right iliac fossa pain were enrolled. Patients were categorized into two groups according to serum bilirubin levels: hyperbilirubinemia (>1 mg/dl) and normal bilirubin (≤1 mg/dl). Operative findings and histology were regarded as the gold standard. Statistical Analysis Used: Chi-square test and diagnostic accuracy measures. Results: Hyperbilirubinemia demonstrated a statistically significant correlation with complex appendicitis (p < 0.001). Serum bilirubin exhibited significant sensitivity and negative predictive value in predicting complicated appendicitis. Conclusions: Hyperbilirubinemia is a valuable adjunctive diagnostic marker for complicated appendicitis; nevertheless, its limited specificity diminishes its capacity to reliably differentiate appendicitis from non-appendicular pathology. Key Messages 1. Hyperbilirubinemia has a significant association with complicated appendicitis. 2. Normal bilirubin levels can help distinguishing severe appendicitis due to high negative predictive value. 3. Serum bilirubin is a simple, cost-effective adjunct in pre-operative assessment.

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