García AIA, Bracho BE

Language: Spanish
References: 13
Page: 314-317
PDF size: 144.89 Kb.

ABSTRACT

Introduction: acute appendicitis is the most common cause of surgical emergency in patients with acute abdomen and has an incidence of perforation ranging from 13 to 37%. Its clinical diagnosis is challenging and involves an adequate synthesis of clinical, laboratory, and radiological findings, so it is essential to find predictive factors such as hyperbilirubinemia that allow the prevention of significant complications. Objective: this study seeks the usefulness of hyperbilirubinemia as a predictor of acute perforated appendicitis. Material and methods: an analytical retrospective cross-sectional observational study was carried out in which 100 records of patients treated for acute appendicitis were reviewed between January 2017 and January 2022. Results: 20% of the patients with complicated appendicitis (abscessed, necrotic, and perforated) presented hyperbilirubinemia. However, no statistical significance was found between the values of total bilirubin and the cases of acute perforated appendicitis (p = 0.311). Conclusion: hyperbilirubinemia as a predictive factor does not help diagnose acute perforated appendicitis.

REFERENCES

1. Bakshi S, Mandal N. Evaluation of role of hyperbilirubinemia as a new diagnostic marker of complicated appendicitis. BMC Gastroenterol [Internet]. 2021; 21 (1): 1-16. Available in: https://doi.org/10.1186/s12876-021-01614-x

2. Di Saverio S, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg. 2020; 15 (1): 27.

3. Fischer JE. Mastery of surgery. Philadelphia: Wolters Kluwer; 2012. p. 1374.

4. Adams HL, Jaunoo SS. Hyperbilirubinaemia in appendicitis: the diagnostic value for prediction of appendicitis and appendiceal perforation. Eur J Trauma Emerg Surg. 2016; 42 (2): 249-252.

5. Flum DR. Acute appendicitis — appendectomy or the "antibiotics first" strategy. N Engl J Med. 2015; 372 (20): 1937-1943.

6. Akai M, Iwakawa K, Yasui Y, Yoshida Y, Kato T, Kitada K et al. Hyperbilirubinemia as a predictor of severity of acute appendicitis. J Int Med Res. 2019; 47 (8): 3663-3669.

7. Sand M, Bechara FG, Holland-Letz T, Sand D, Mehnert G, Mann B. Diagnostic value of hyperbilirubinemia as a predictive factor for appendiceal perforation in acute appendicitis. Am J Surg. 2009; 198 (2): 193-198. doi: 10.1016/j.amjsurg.2008.08.026.

8. Atahan K, Ureyen O, Aslan E, Deniz M, Cokmez A, Gür S et al. Preoperative diagnostic role of hyperbilirubinaemia as a marker of appendix perforation. J Int Med Res. 2011; 39 (2): 609-618. doi: 10.1177/147323001103900230.

9. Ghimire P, Thapa P, Yogi N, Ghimire P. Role of serum bilirubin as a marker of acute gangrenous appendicitis. Nepal J Med Sci. 2012; 1 (2): 89-92.

10. Kaser SA, Fankhauser G, Willi N, Maurer CA. C-reactive protein is superior to bilirubin for anticipation of perforation in acute appendicitis. Scand J Gastroenterol. 2010; 45 (7-8): 885-892. doi: 10.3109/00365521003728572.

11. Kim DY, Nassiri N, de Virgilio C, Ferebee MP, Kaji AH, Hamilton CE et al. Association between hyponatremia and complicated appendicitis. JAMA Surg. 2015; 150 (9): 911-912.

12. Anand S, Krishnan N, Birley JR, Tintor G, Bajpai M, Pogorelic Z. Hyponatremia-A new diagnostic marker for complicated acute appendicitis in children: a systematic review and meta-analysis. Children (Basel). 2022; 9 (7): 1070. doi: 10.3390/children9071070.

13. Besli GE, Cetin M, Ulukaya Durakbasa C, Ozkanli S. Predictive value of serum sodium level in determining complicated appendicitis risk in children. Haydarpasa Numune Med J. 2019; 59 (1): 35-40. doi: 10.14744/hnhj.2019.16013.