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Article

Bilirubin is a specific marker for the diagnosis of acute appendicitis

  • Authors:
    • Dimitrios Zosimas
    • Panagis M. Lykoudis
    • Giuseppe Strano
    • Josh  Burke
    • Eyad Al‑Cerhan
    • Veeranna Shatkar
  • View Affiliations / Copyright

    Affiliations: Department of General Surgery, Queen's Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford RM7 0AG, UK, Division of Surgery and Interventional Science, University College London, London WC1E 6BT, UK
  • Article Number: 1056
    |
    Published online on: July 23, 2021
       https://doi.org/10.3892/etm.2021.10490
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Abstract

Total serum bilirubin and other biochemical parameters have been associated with acute appendicitis, mainly in complicated cases. The present study aimed to evaluate the role of biochemical parameters in the diagnosis of acute appendicitis, and to further investigate the role of bilirubin as a diagnostic marker irrespective of the severity of the pathology. All recorded cases of appendicectomies in a 1‑year period in a single institution were reviewed. The median values of white cell count, C‑reactive protein and total serum bilirubin on admission were associated with final histology, and their respective rates of abnormal and normal values were compared between patients who were proven to have negative histology and patients who were proven to have acute appendicitis. A total of 300 patients were studied. Median total serum bilirubin, white cell count and C‑reactive protein on admission were significantly associated with acute appendicitis (P<0.001). Respective rates of normal and abnormal values were significantly associated with final histology (P<0.001). Total serum bilirubin demonstrated higher specificity (0.88) but lower sensitivity (0.26) and diagnostic accuracy (0.40) for acute appendicitis. In conclusion, total serum bilirubin on admission should be considered in the diagnostic workup to confirm rather than exclude appendicitis, without focusing on subgroups of specific severity of the disease. White cell count and C‑reactive protein may also contribute to the diagnostic work‑up, although with limited accuracy.
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Copy and paste a formatted citation
Spandidos Publications style
Zosimas D, Lykoudis PM, Strano G, Burke J, Al‑Cerhan E and Shatkar V: Bilirubin is a specific marker for the diagnosis of acute appendicitis. Exp Ther Med 22: 1056, 2021.
APA
Zosimas, D., Lykoudis, P.M., Strano, G., Burke, J., Al‑Cerhan, E., & Shatkar, V. (2021). Bilirubin is a specific marker for the diagnosis of acute appendicitis. Experimental and Therapeutic Medicine, 22, 1056. https://doi.org/10.3892/etm.2021.10490
MLA
Zosimas, D., Lykoudis, P. M., Strano, G., Burke, J., Al‑Cerhan, E., Shatkar, V."Bilirubin is a specific marker for the diagnosis of acute appendicitis". Experimental and Therapeutic Medicine 22.4 (2021): 1056.
Chicago
Zosimas, D., Lykoudis, P. M., Strano, G., Burke, J., Al‑Cerhan, E., Shatkar, V."Bilirubin is a specific marker for the diagnosis of acute appendicitis". Experimental and Therapeutic Medicine 22, no. 4 (2021): 1056. https://doi.org/10.3892/etm.2021.10490
Copy and paste a formatted citation
x
Spandidos Publications style
Zosimas D, Lykoudis PM, Strano G, Burke J, Al‑Cerhan E and Shatkar V: Bilirubin is a specific marker for the diagnosis of acute appendicitis. Exp Ther Med 22: 1056, 2021.
APA
Zosimas, D., Lykoudis, P.M., Strano, G., Burke, J., Al‑Cerhan, E., & Shatkar, V. (2021). Bilirubin is a specific marker for the diagnosis of acute appendicitis. Experimental and Therapeutic Medicine, 22, 1056. https://doi.org/10.3892/etm.2021.10490
MLA
Zosimas, D., Lykoudis, P. M., Strano, G., Burke, J., Al‑Cerhan, E., Shatkar, V."Bilirubin is a specific marker for the diagnosis of acute appendicitis". Experimental and Therapeutic Medicine 22.4 (2021): 1056.
Chicago
Zosimas, D., Lykoudis, P. M., Strano, G., Burke, J., Al‑Cerhan, E., Shatkar, V."Bilirubin is a specific marker for the diagnosis of acute appendicitis". Experimental and Therapeutic Medicine 22, no. 4 (2021): 1056. https://doi.org/10.3892/etm.2021.10490
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