ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2016
Hyperbilirubinaemia in appendicitis: the diagnostic value for prediction of appendicitis and appendiceal perforation.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Effects of clinical nursing pathway on surgical site wound infection in patients undergoing acute appendicitis surgery: A meta-analysis.International wound journal · 2024Pooled it
- Salivary Biomarkers in Pediatric Acute Appendicitis: Current Evidence and Future Directions.Children (Basel, Switzerland) · 2025Review
- Diagnostic value of biochemical markers in prediction of perforation in acute appendicitis: a cross-sectional study.Annals of medicine and surgery (2012) · 2024Article
- Elevated total and direct bilirubin are associated with acute complicated appendicitis: a single-center based study in Saudi Arabia.BMC surgery · 2023Observational
- Predicting complicated appendicitis is possible without the use of sectional imaging-presenting the NoCtApp score.International journal of colorectal disease · 2023Article
- A new, simple marker for predicting complicated appendicitis in patients with normal white blood cell count indicator; LUC.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2023Article
- Hyperfibrinogenemia and hyponatremia as predictors of perforated appendicitis in children: A retrospective cohort study.International journal of colorectal disease · 2023Article
- Hyperbilirubinemia and Hyponatremia as Predictors of Complicated Appendicitis.Medical sciences (Basel, Switzerland) · 2022Article
- Article
- Bilirubin is a specific marker for the diagnosis of acute appendicitis.Experimental and therapeutic medicine · 2021Article
- Relationship between appendicitis and diameter of ileocecal lipomatosis and also ileocecal angle.Surgical and radiologic anatomy : SRA · 2020Article
- Article
- Delta neutrophil index: A reliable marker to differentiate perforated appendicitis from non-perforated appendicitis in the elderly.Journal of clinical laboratory analysis · 2018Article
- Letter to the Editor regarding Adams HL, Jaunoo SS. Hyperbilirubinaemia in appendicitis: the diagnostic value for prediction of appendicitis and appendiceal perforation. Eur J Trauma Emerg Surg. 2016; 42:249-52.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2016Article
- International normalized ratio and serum C-reactive protein are feasible markers to predict complicated appendicitis.World journal of emergency surgery : WJES · 2016Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThe aim of this study is to evaluate the diagnostic value of pre-operative bilirubin levels in the diagnosis of acute appendicitis and appendiceal perforation.
methodA retrospective analysis of 557 patients undergoing emergency appendicectomy over a 24-month period at a large teaching hospital. Hyperbilirubinaemia was defined as >25 µmol/L. Data were analysed using descriptive statistics.
results484 of the 557 (86.9 %) operated cases were found histologically to be appendicitis. 116 cases of the 484 were perforated (24 %). Bilirubin levels were significantly higher in the group with appendicitis versus the group found to have a normal appendix at histology, [median (IQR) 12.0 µmol/L (9.00) vs. 8.0 µmol/L (7.00) respectively, p < 0.001], despite being within normal serum bilirubin range. Sensitivity of hyperbilirubinaemia for acute appendicitis was only 8 %, however specificity was 94 %. PPV was 85 % and NPV was 26 %. Whilst bilirubin was higher in patients with a perforated appendix versus acute appendicitis [median (IQR) 13.0 µmol/L (9.00) vs. 11.0 µmol/L (9.00), respectively], statistically, there was no significant difference in pre-operative bilirubin levels between the perforated appendicitis cases and the non-perforated appendicitis cases (p = 0.326). However, the specificity of hyperbilirubinaemia for perforated appendicitis was 93 %, sensitivity 9.4 %, PPV 24 % and NPV 82 %.
conclusionBilirubin levels may be high, but remain within normal range, in cases of appendicitis. Therefore, bilirubin levels may be a useful measurement when investigating a patient with suspected appendicitis. Hyperbilirubinaemia is highly specific with regards to perforation, a finding supported by other studies. However, possibly because of the few perforated cases in this study, we cannot recommend that hyperbilirubinaemia be used to predict perforation.
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