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EMJ Online First, published on December 4, 2014 as 10.1136/emermed-2013-203349 Original article

Diagnostic accuracy of hyperbilirubinaemia in anticipating appendicitis and its severity Sven Muller, Claudius Falch, Steffen Axt, Peter Wilhelm, Dirk Hein, Alfred Königsrainer, Andreas Kirschniak Working Group for Surgical Technology and Training, Clinic for Visceral, General and Transplant Surgery, Tübingen University Hospital, Tübingen, Germany Correspondence to Dr Andreas Kirschniak, Working Group for Experimental Minimally Invasive Surgery and Training, Clinic for General, Visceral and Transplant Surgery, Tübingen University Hospital, Waldhörnlestrasse 22, Tübingen 72072, Germany; [email protected] Received 15 November 2013 Revised 16 September 2014 Accepted 10 November 2014

ABSTRACT Background Hyperbilirubinaemia is reported to be a positive predictor in diagnosing appendicitis and especially appendiceal perforation. We, therefore, analysed the diagnostic accuracy of serum bilirubin in anticipating appendicitis and its severity. Methods All consecutive patients undergoing appendectomy for suspected appendicitis from May 2009 to August 2011 were analysed. Patients were classified based on final histopathological findings into the groups: no appendiceal inflammation, non-perforated appendicitis and perforated appendicitis. Primary outcome was the diagnostic accuracy of serum bilirubin levels in discriminating between no appendiceal inflammation and any appendicitis ( perforated and nonperforated appendicitis) and non-perforated and perforated appendicitis. Results Of 493 analysed patients, 125 (25%) had no appendiceal inflammation, 312 (64%) had nonperforated appendicitis and 56 (11%) had perforated appendicitis. The proportion of patients with bilirubin elevation (>1.1 mg/dL) was different between those with no appendiceal inflammation (14%) and any appendicitis (36%) ( p

Diagnostic accuracy of hyperbilirubinaemia in anticipating appendicitis and its severity.

Hyperbilirubinaemia is reported to be a positive predictor in diagnosing appendicitis and especially appendiceal perforation. We, therefore, analysed ...
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