Vol. 6, Issue 4 (2020)
Evaluation of liver function tests in pathological appendix
Author(s): Shyam Sunder Nagpal, Arun Kumar
Abstract: Introduction: Acute appendicitis (AA) is the most common surgical disease with life time risk of 7-8% and appendectomy is the treatment of choice in majority of cases. Although acute appendicitis is the most common surgically correctable cause of abdominal pain, the diagnosis is highly challenging. Recent research literatures have hyperbilirubinemia is a diagnostic gangrenous/perforation of appendix. In some literature it has mentioned that hyperbilirubinemia is a predictor of severity of acute appendicitis. Materials and Methods: 82 consecutive cases of acute appendicitis admitted to surgery unit, irrespective of age and sex were recruited for the study. We have included clinically diagnosed (Alvarado score ≥7) and USG confirmed subjects of acute appendicitis and its complications. The patients with the cases of acute appendicitis and its complications with liver disease due to any cause, history of alcohol intake and AST/ALT >2, history of jaundice and history of hepatotoxic drug intake were excluded. After taking informed consents, all patients included in the study were subjected to abdominal ultrasound and blood sample taken for routine blood examination, LFT and after appendicectomy histopathology examination report were collected. Results: Out of 82 subjects, 51 were males and 31 were females. On histopathological and intraoperative examination, 11% had normal appendix, 13% had perforated appendix, 27% had gangrenous appendix and 49% had inflamed appendix respectively. Liver function tests were evaluated in these subjects, we found that in subjects with inflamed appendix 8/40, 6/40, 2/40 had elevated levels of total bilirubin, AST, ALT respectively and none had elevated ALP. Similarly, in subjects with perforated/gangrenous appendix 28/33, 18/33, 8/33 and 7/33 had elevated total bilirubin, AST, ALT and ALP levels respectively. Conclusion: LFT can be added as adjunctive test to the investigation of acute appendicitis and its complications and earlier diagnosis of the complications of acute appendicitis and timelier management.