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Serum total bilirubin elevation is a predictor of the clinicopathological severity of acute appendicitis.

Authors :
Nomura S
Watanabe M
Komine O
Shioya T
Toyoda T
Bou H
Shibuya T
Suzuki H
Uchida E
Source :
Surgery today [Surg Today] 2014 Jun; Vol. 44 (6), pp. 1104-8. Date of Electronic Publication: 2013 Jul 24.
Publication Year :
2014

Abstract

Purpose: Elevation of the serum total bilirubin (STB) level not stemming from hepatic dysfunction or biliary obstruction may be seen in cases of acute appendicitis. This paper deals with the clinical significance of such elevations.<br />Methods: Data from 410 appendectomized patients classified into two groups (a high preoperative STB group and a normal preoperative STB group) were analyzed to reveal the significance of preoperative hyperbilirubinemia. We also examined whether the preoperative STB level might serve as a risk factor for gangrenous appendicitis by a multivariate analysis.<br />Results: Gangrenous appendicitis was more common in the high preoperative STB group (p < 0.001). The multivariate analysis revealed that an elevated preoperative STB level (odds ratio 1.7919) was a risk factor for gangrenous appendicitis.<br />Conclusion: In patients with an elevated preoperative STB level, it is very likely that the inflammation is severe and that the disease has progressed to a severe condition histopathologically; therefore, meticulous attention should be paid to the selection of the surgical procedure, as well as to the postoperative clinical course.

Details

Language :
English
ISSN :
1436-2813
Volume :
44
Issue :
6
Database :
MEDLINE
Journal :
Surgery today
Publication Type :
Academic Journal
Accession number :
23880964
Full Text :
https://doi.org/10.1007/s00595-013-0659-5