EP-623 Can we count on serum hyperbilirubinemia to predict acute complicated appendicitis?. (9th August 2022)

• Record Type: Journal Article
• Authors: Jaskani, Sadia; Al-Hamid, Zaid
• Is Part Of: British journal of surgery. Volume 109(2022)Supplement 5
• Publication Date: 2022-08-09
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znac245.159
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Introduction and Aims: Acute appendicitis (AA) is usually a clinical diagnosis and surgical intervention is typically a preferred choice to avoid potentially lethal complications. The aim of this study was to evaluate hyperbilirubinemia as a predictor of complicated acute appendicitis (CA). Material and Methods: A retrospective analysis of patients who underwent surgery for AA in a district general hospital in the UK from Jan 2018 to April 2019. It includes White cell count (WCC), C- reactive proteins (CRP), and liver function tests (LFTs). Results: A total of 236 (Median age = xx, IQR, F: M = 1:1.4). The frequency of normal, uncomplicated, and complicated appendicitis was 25(10.6%), 161 (68.2%), and 50 (21.2%), respectively. There were significant differences in the rate of negative appendicectomy in females (9.3% F vs 1.3% M, p-VALUE=0.0001). The bilirubin levels mirrored the CRP levels and showed statistically significant difference in patients with normal versus uncomplicated/complicated appendicitis (Bilirubin = 8.36 in normal versus 12.39 in uncomplicated and 16.44 in complicated appendicitis, p value=0.0001; CRP= 34.09 in normal versus 44.38 in uncomplicated and 114.34 in complicated appendicitis, p value=0.0001). The Neutrophil count showed increased differences between normal and uncomplicated/complicated appendicitis (Neutrophil 8.4 vs 11.2, p-value0.016; WCC 11.8 vs 14.1, p-value=0.003). In the negative appendicectomy group, 17/25 had preoperative imaging. In 7/25 (28%) imaging was suspicious of appendicitis, 10/25 (40%) had normal findings and 8/25 patients did not have any prior imaging. Conclusion: SB had low sensitivity and high specificity as compared to CRP and WCC for AA.