The utility of serum of bilirubin as a marker in acute abdomen.

Abstract

BACKGROUND: Delay in diagnosis leads to various complications like perforation, abscess formation. Evaluation of serum bilirubin helps in diagnosis of complications, like perforation, morbidity, wound infection, prognosis associated with acute abdomen. The aim of the study is to evaluate serum bilirubin levels to predict complications prior to surgery. METHODS: This is a descriptive cross-sectional study which includes 164 study subjects diagnosed with acute abdomen such as appendicitis, peritonitis, cholecystitis. All study subjects were subjected to clinical evaluation, Laboratory investigations such as liver function tests, ultrasound and x ray abdomen in erect posture. The data was compiled and analysed. The Fisher's exact, Pearson's χ2, ANOVA, and Kruskal–Wallis tests while logistic regression for multivariate analysis was performed. p < 0.05 was accepted as statistically signicant Results: In our study patients diagnosed with acute appendicitis 35 cases showed elevated WBC count mean 9.81 ±SD 3.254. 7 cases showed raised TDB 0.50 SD± 0.526. In acute appendicitis with perforation 25 cases had raised WBC counts mean 12.13±SD 3.764. 3 cases had increased levels of TDB mean 1.32±SD 0.9333. WBC, TDB levels are increased among patients with acute appendicitis with perforation compared to patients with acute appendicitis which is statistically signicant (p₌0.002 and 0.001 respectively). Conclusion: Hyperbilirubinemia, especially with elevated direct bilirubin levels, may be considered as an important marker for the prediction of appendiceal gangrene/perforation which is cost effective in a rural set up where CT scan cannot be performed.