Background: Elevation in serum bilirubin is reported to have a predictive potential for the diagnosis of complicated appendicitis, the pro inflammatory mediators tend to reach liver via superior mesenteric vein and may directly or indirectly produce liver dysfunction thus implying a credibility of serum bilirubin as the biological marker to predict and differentiate Appendicitis.

Aims & Objectives: To Study the relationship between hyperbilirubinemia and acute appendicitis and to evaluate whether elevated bilirubin level are of predictive value in diagnosis of complicated appendicitis.

Methods: This comparative clinical study of 100 patients who attended surgical outpatient department/admitted to tertiary care hospital presenting with pain at RIF region with fever & vomiting were included. After admission, the data collected regarding clinical history, examination, diagnosis, investigations, and details of previous operative procedure. Post operative follow up done to note the complications both in hospital and after discharge for 3 months. Result: Out of 100 patients, 69 patients had raised bilirubin levels (>1.0 mg/dL). 32 patients diagnosed as complicated appendicitis. Among them 29 patients (90.62%) had raised bilirubin levels (>1.0 mg/dL). 40 (58.82%) patients of the total patients diagnosed with Acute uncomplicated appendicitis were found to have elevated bilirubin levels (>1.0 mg/dL).

Conclusion: We concluded that Hyperbilirubinemia found to b a new predictor of acute appendicitis, also found that Bilirubin level significantly (>1.0) raised in acute Uncomplicated Appendicitis & Complicated Appendicitis.