scholarly journals Evaluating serum bilirubin levels in acute appendicitis and appendiceal perforation

2020 ◽  
Vol 8 (3) ◽  
pp. 859
Author(s):  
Rajandeep Singh Bali ◽  
Rajni . ◽  
Yawar Watali ◽  
Shyam Kumar Gupta ◽  
Geetanjali Gupta
Keyword(s):  
Retrospective Study ◽  
Acute Appendicitis ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Study Group ◽  
Surgical Emergencies ◽  
Diagnostic Modalities ◽  
Tertiary Care Hospitals ◽  
Appendiceal Perforation

Background: Acute appendicitis is one of the commonest surgical emergencies. Authors undertook this study to evaluate serum bilirubin levels in acute appendicitis and appendiceal perforation.Methods: A retrospective study evaluating the serum bilirubin levels in acute appendicitis and appendiceal perforation was carried out for 6 years at three tertiary care hospitals at India from 2014 to 2019. Patients having acute appendicitis and appendiceal perforation, confirmed on histopathology, with no other medical or surgical comorbidity were included in the study.Results: The total number of our study subjects was 927. 306 patients had appendiceal perforation, amongst these, 226 (74%) had hyperbilirubinemia. Out of the 621 patients having acute appendicitis only 186 (30%) had hyperbilirubinemia. The lowest and the highest serum bilirubin levels of this study group were 0.6 and 3.1 mg/dl, respectively, with an average of 1.6 mg/dl. In patients diagnosed to be having acute appendicitis, the lowest and highest serum bilirubin levels were 0.6 and 2.4 mg/dl, respectively, with an average of 1.3 mg/dl. As for the patients having appendiceal perforation the lowest and highest serum bilirubin levels were 0.8 and 3.1 mg/dl, respectively, with an average of 1.8 mg/dl.Conclusions: Hyperbilirubinemia is seen in acute appendicitis but predominantly in appendiceal perforation, so serum bilirubin estimation may help us in diagnosing appendiceal perforation pre-operatively if and when used in conjunction with other available diagnostic modalities.

scholarly journals Clinical-epidemiological profile of acute appendicitis at tertiary care institute of Bhuj, Kutch: a retrospective study

2019 ◽  
Vol 6 (4) ◽  
pp. 1368
Author(s):  
Kamlesh Vegad ◽  
Ghanshyam Parmar
Keyword(s):  
Retrospective Study ◽  
Acute Appendicitis ◽  
Tertiary Care ◽  
Young Males ◽  
Patient Demographics ◽  
Care Institute ◽  
Surgical Emergencies ◽  
Evolutionary Phase ◽  
Epidemiological Profile ◽  
Operative Findings

Background: Acute appendicitis is one of the commonest surgical emergencies in all ages and the importance of specific elements in the clinical diagnosis remains controversial. Present study was performed with an aim to determine the presenting pattern of acute appendicitis and to review the pathological diagnosis.Methods: Present retrospective study was conducted in 115 patients who had appendicectomy for acute appendicitis at the Department of Surgery, tertiary care institute of Gujarat, India for the period of 1 year. The complaints and physical examination findings of the patients were obtained from their medical files Patient demographics, clinical features, operative findings and histology results were recorded on a special patient proforma.Results: Out of the total of 115 patients studied, 70 were males while 45 were females. The most common presenting complaints were abdominal pain (n=115), Nausea (n=55), vomiting (n=77) and diarrhoea (n=14). At surgery, 68.6% of appendices were apparently inflamed.1.7% were perforated and 5.2% had appendicular abscess whereas in 24.3% cases faecolith with inflammation was present. Sixty percent of the patients were discharged on the 4th day, 5.2% were discharged on 5th day, 4.3% on 6th day, 25.2% on 7th day and 3.4% on 8th day and 1.7% had a hospital stay of 10 or more days.Conclusions: Present study shows that acute appendicitis in India is a disease of young males. Hospitalization time was directly associated with the evolutionary phase and increased with the severity of appendicitis.

scholarly journals Nosocomial Infections in Tbilisi, Georgia: A Retrospective Study of Microbiological Data from 4 Major Tertiary Care Hospitals

2011 ◽  
Vol 32 (9) ◽  
pp. 933-934
Author(s):  
George Kandelaki ◽  
Maia Butsashvili ◽  
Mariam Geleishvili ◽  
Nato Avaliani ◽  
Nino Macharashvili ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Nosocomial Infections ◽  
Tertiary Care ◽  
Tertiary Care Hospitals ◽  
Microbiological Data

scholarly journals ROLE OF HYPERBILIRUBINEMIA, ELEVATED CREACTIVE PROTEIN AND LEUCOCYTE COUNT AS A PREDICTIVE FACTOR FOR APPENDICEAL PERFORATION IN ACUTE APPENDICITIS

2021 ◽  
pp. 1-3
Author(s):  
Nagendra Singh Bhadauria ◽  
Pawan Kumar ◽  
Gunjan Sharma ◽  
Amit Singh
Keyword(s):  
Acute Appendicitis ◽  
Tertiary Care ◽  
Diagnostic Value ◽  
Primary Data ◽  
Laboratory Marker ◽  
Reactive Protein ◽  
Life Threatening ◽  
Perforated Appendix ◽  
Appendiceal Perforation

Background: Appendiceal perforation in patients with acute appendicitis may cause a variety of potentially life-threatening complications. Escherichia coli endotoxin has been shown to impact physiological bile flow in vivo. This had led to the theory that hyperbilirubinemia and elevated CRP in patients with appendicitis may have a predictive potential for the preoperative diagnosis of appendiceal perforation. Objectives: The aim of this retrospective study was to investigate the diagnostic value of hyperbilirubinemia and elevated CRP as a preoperative laboratory marker for appendiceal perforation in patients with acute appendicitis. Thus a new marker for appendiceal perforation would be welcomed. Thus, the need for the study is to conclude whether the Serum Bilirubin or CRP can be considered as a new laboratory marker to aid in the diagnosis of Appendicular Perforation. Materials and methods: All patients admitted with clinical diagnosis of "Acute Appendicitis" or "Appendicular Perforation" and undergoing surgery in General Surgery Dept in Tertiary Care Teaching Hospital were taken as Subjects for this study. The primary data for this study were the blood investigations of the patients. 200 patients with concerned consent and meeting the inclusion criteria were included in the study. The necessary clinical and lab details were obtained in a prewritten format. The intraoperative findings were noted and documented precisely. Upon completion of data collection the preoperative bilirubin levels of the perforated and uncomplicated groups wereOther clinical and lab parameters obtained during the study were compared between the two groups. All parameters were subjected to statistical analysis and evaluated critically. Results: A total of 200 patients participated in the study. Of the 200 patients studied 132 patients were males and 68 patients were females. The youngest patient was 13 years old and the oldest 64 years. Among all the patients operated with a diagnosis of Acute Appendicitis 92 were found to have a perforated appendix, and 108 were found to have a non-perforated appendix. It was observed that among 92 patients with perforated appendix 86 patients showed a raised CRP levels and 58 patients had a raised Bilirubin levels. However in case of non-perforated cases it was found that among the 108 cases 82 patients had a raised CRP levels and 36 patients showed raised bilirubin levels. Conclusion: Hence Logistic Regression technique revealed that the C- reactive protein and Hyperbilirubinemia can be used to predict the appendicular perforation preoperatively and that their roles are comparable and that there is no definitive advantage of one over the other for the same.

scholarly journals Clinicopathological correlation of acute appendicitis undergoing emergency appendicectomy in a tertiary care hospital of Gujarat: a retrospective study

2019 ◽  
Vol 6 (9) ◽  
pp. 3201
Author(s):  
Mrugesh Chudasama ◽  
Pallav Patel
Keyword(s):  
Retrospective Study ◽  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Tertiary Care ◽  
Clinical Signs ◽  
Vermiform Appendix ◽  
Study Patient ◽  
Care Hospital ◽  
Delayed Presentation ◽  
Operative Findings

Background: Acute appendicitis is acute inflammation and infection of the vermiform appendix, which is most commonly referred to simply as the appendix. The aim of this study was to determine the presenting pattern of acute appendicitis and to review the pathological diagnosis.Methods: This retrospective study was conducted in the general surgery department at tertiary care institute of Gujarat for the period of one year. One hundred patients who were attending department of surgery diagnosed as acute appendicitis were selected for the study. Patient demographics, clinical features, operative findings and histology results were recorded on a special patient proforma.Results: The most common presenting complaints were abdominal pain (n=100), nausea (n=54), vomiting (n=80) and diarrhoea (n=7). As for clinical signs 100% of the patients in this study had some degree of right iliac fossa tenderness. Open appendicectomy was performed in 62% of the patients and laparoscopic appendicectomy in 38% of the patients. 66% of the patients presented within 24 hours of the onset of symptoms whereas 28% presented 24-48 hours after the onset of symptoms.Conclusions: Diagnosis of acute appendicitis obvious based on strongly positive clinical presentation. Present study shows that acute appendicitis in India is a disease of young males. On further sub-classification of acute appendicitis, uncomplicated acute appendicitis seems to be the most common. Delayed presentation is associated with greater morbidity. 

scholarly journals The decrease of non-complicated acute appendicitis and the negative appendectomy rate during pandemic

2021 ◽  
Author(s):  
Marco Ceresoli ◽  
◽  
Federico Coccolini ◽  
Stefano Magnone ◽  
Alessandro Lucianetti ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Acute Appendicitis ◽  
Operative Treatment ◽  
Clinical Presentation ◽  
Control Period ◽  
Negative Appendectomy ◽  
Treatment Rate ◽  
Surgical Emergencies ◽  
Negative Appendectomy Rate ◽  
Complicated Acute Appendicitis

Abstract Background During pandemic, admissions for surgical emergencies dropped down dramatically. Also acute appendicitis decreased. The aim of the present study was to evaluate the change in volume and clinical presentation of patients with acute appendicitis during pandemic and the variation in treatment. Methods This is a retrospective study of patients admitted in 11 Italian hospital for acute appendicitis during the lockdown period (March–April 2020) compared with the same period of the previous 2 years (2018–2019). The number and the rate of complicated and non-complicated acute appendicitis were recorded and compared between the two study periods; non-operative vs operative treatment and negative appendectomy rate were also recorded. Results The study included 532 patients, 112 in the study period and 420 in the control period; Hospital admission for acute appendicitis dropped by 46% (OR 0.516 95% CI 0.411–0.648 p < 0.001) during the 2020 lockdown. The number of complicated acute appendicitis did not change (− 18%, OR 0.763 95% CI 0.517–1.124 p = 0.1719), whereas the number of non-complicated acute appendicitis significantly decreased (− 56%, OR 0.424 95% CI 0.319–0.564 p < 0.001). Non-operative treatment rate remained similar (12.1% vs. 11.6% p = 0.434). The negative appendectomy rate also significantly decreased (6.1% vs. 17.3%, p = 0.006). Conclusions The present study found a significant reduction of both admissions for non-complicated acute appendicitis and negative appendectomy rate during the pandemic period. Conversely, admissions for complicated acute appendicitis did not change. Trial registration: NCT04649996.

DIAGNOSTIC VALUE OF HYPERBILIRUBINEMIA IN ACUTE APPENDICITIS AND APPENDICULAR PERFORATION

2021 ◽  
pp. 1-3
Author(s):  
Baburam Basumatary ◽  
Abhigyan Borkotoky
Keyword(s):  
Acute Appendicitis ◽  
Serum Bilirubin ◽  
Delayed Diagnosis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Diagnostic Value ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Clinical Signs And Symptoms ◽  
Appendiceal Perforation

Introduction: Misdiagnosis or delayed diagnosis of acute appendicitis may result in perforation and will increase the mortality and morbidity of patients. Serum Bilirubin may be an aid in the diagnosis of appendiceal perforation. Methods: A study was conducted in the Department of Surgery, Assam Medical College, from November 2019 to November 2020. A total of 50 patients with clinical diagnosis of acute appendicitis or appendicular perforation were studied. The serum bilirubin estimation was carried out in all the patients. Result:Serum Bilirubin was elevated in the patients with both acute appendicitis and appendicular perforation. Conclusion: Serum Bilirubin has a predictive potential for the diagnosis of acute appendicitis and appendicular perforation. Patients who present with clinical signs and symptoms of appendicitis and a raised bilirubin level should be identied as having a higher probability of appendicular perforation.

scholarly journals Diagnostic value of serum hyperbilirubinemia in acute appendicitis and its complications

2017 ◽  
Vol 4 (5) ◽  
pp. 1710
Author(s):  
Farooq A. Mir ◽  
Shaugfta Aara ◽  
Masrat Jan ◽  
Nisar A. Wani
Keyword(s):  
Acute Appendicitis ◽  
Bilirubin Level ◽  
Predictive Factor ◽  
Serum Bilirubin ◽  
Perforated Appendicitis ◽  
Diagnostic Value ◽  
Significant Difference ◽  
Perforated Appendix ◽  
The Mean ◽  
Appendiceal Perforation

Background: To increase diagnostic accuracy and to decrease complication rates secondary to acute appendicitis, a variety of different approaches have been described, including predictive scoring systems. To prevent the catastrophic effects of perforated appendix, a surgeon needs diagnostic tools which may signal perforation of appendix at earliest, as a result of which the delay in the management of perforated appendix will not be witnessed. Keeping in view the above facts, the diagnostic value of serum bilirubin in acute appendicitis and its complications has been evaluated.Methods: This prospective study was conducted on 100 patients who presented with clinical diagnosis of Acute Appendicitis. Role of serum bilirubin as a diagnostic tool in acute appendicitis and diagnostic value of hyperbilirubinemia as a predictive factor for appendiceal perforation was evaluated. . Estimation of serum bilirubin was done by Jendrassik and Gorf method using Hitachi – 912 automatic biochemistry analyzer. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the investigations in the diagnosis of the acute appendicitis were calculated.Results: Serum bilirubin levels had a sensitivity of 84.1% and specificity of 83.3% in the diagnosis of acute appendicitis. The mean bilirubin level of patients with gangrenous appendicitis (2.1±1.2mg/dl) was significantly higher than the mean bilirubin level of patients with simple acute appendicitis (1.5 ±0.6)   (p1=0.030 sig). A statistically significant difference was also observed in the mean bilirubin level of patients with perforated appendicitis (mean=2.9±1.6mg/dl) and mean bilirubin level of patients with simple acute appendicitis (p2=<0.0001 sig). However statistically non-significant difference was observed between the mean bilirubin level of patients with gangrenous and perforated appendicitis (p3=0.056 non- sig).Conclusions:Pre-operative assessment of serum bilirubin not only helps in acute appendicitis but also serves as a predictive factor for appendiceal perforation. 

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