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Peer-reviewedCC BY-NC-SAAfrican Journal of Paediatric Surgery

Role of Hyperbilirubinaemia as a Predictor of Complicated Appendicitis in Paediatric Population

  • Dinesh Prasad Koirala1,2
  • Amit Kumar Gupta3,4
  • Geha Raj Dahal5,2
  • Bibek Man Shrestha6,7
  • Suraj Shrestha6,8
  • Subita Neupane9,8
  • Rameshwar Prasad Pokharel5,2
9 affiliations
  1. 1Pediatric Surgery Unit , Tribhuvan University Teaching Hospital , Institute of Medicine , Kathmandu , Nepal
  2. 2Department of General Surgery, Pediatric Surgery Unit, Tribhuvan University Teaching Hospital, Institute of Medicine, Lucknow, Uttar Pradesh, India
  3. 3Department of General Surgery , Pediatric Surgery Unit , Tribhuvan University Teaching Hospital , Institute of Medicine , Department of Surgery ,
  4. 4Department of Surgery, Mayo Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  5. 5National Academic of Medical Sciences , BIR Hospital , Kathmandu , Nepal
  6. 6Mayo Institute of Medical Sciences , Lucknow , Uttar Pradesh , India, Maharajgunj Medical Campus ,
  7. 7Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal
  8. 8Department of General Practice and Emergency Medicine, National Academic of Medical Sciences, BIR Hospital, Kathmandu, Nepal
  9. 9Institute of Medicine , Department of General Practice and Emergency Medicine ,
Open at sourcePDFDOICite

Abstract

Background: Acute appendicitis is a common surgical emergency amongst the paediatric population. Available diagnostic tools are focussed to make a diagnosis of acute appendicitis. Adefinitive predictive factor for the diagnosis of complicated appendicitis is lacking. Thus, this aims to analyse hyperbilirubinaemia as a predictor of complicated appendicitis amongst the paediatric population. Materials and Methods: Aprospective observational study was conducted in a tertiary hospital from November 2018 to October 2019. All children undergoing emergency appendectomy were included in the study. Preoperatively, patients were evaluated clinically, and routine investigations including total and direct serum bilirubin were sent. All patients were grouped as ‘simple appendicitis’ or ‘complicated appendicitis’ based on intra‑operative and histological findings. Bilirubin level was compared between these groups and analysed. Results: A total of 52 children fulfilling the inclusion criteria were included. The mean age was 13.2 ± 4.2 years, and the male: female ratio was 2.1:1. Thirty‑four (65.4%) had simple appendicitis and 18 (34.6%) had complicated appendicitis. Total bilirubin was 23.83 ± 5.94 mmol/L in the complicated appendicitis group and 13.15 ± 3.29 mmol/L in the simple appendicitis group. Direct bilirubin was 5.28 ± 2.22 mmol/L in complicated appendicitis and 2.62 ± 0.83 mmol/L in simple one. Both total and direct bilirubin were significantly high in the complicated group (P < 0.001) compared to the simple appendicitis group. On the Receiver operating curve (ROC), the best cutoff value for total and direct bilirubin was 21 and 5.5 mmol/L, respectively. The sensitivity and specificity of total and direct bilirubin were 72.2%, 100%, and 61.1%, and 85.3%, respectively. Conclusion: It is concluded that hyperbilirubinaemia is a good predictor for paediatric complicated appendicitis.

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Cite

BibTeXRIS
BibTeX
@article{koirala2026role,
  title = {{Role of Hyperbilirubinaemia as a Predictor of Complicated Appendicitis in Paediatric Population}},
  author = {Dinesh Prasad Koirala and Amit Kumar Gupta and Geha Raj Dahal and Bibek Man Shrestha and Suraj Shrestha and Subita Neupane and Rameshwar Prasad Pokharel},
  journal = {African Journal of Paediatric Surgery},
  year = {2026},
  month = may,
  doi = {10.67481/ajps.v19i2.1029},
  url = {https://doi.org/10.67481/ajps.v19i2.1029},
  note = {CC BY-NC-SA},
}
RIS
TY  - JOUR
TI  - Role of Hyperbilirubinaemia as a Predictor of Complicated Appendicitis in Paediatric Population
AU  - Dinesh Prasad Koirala
AU  - Amit Kumar Gupta
AU  - Geha Raj Dahal
AU  - Bibek Man Shrestha
AU  - Suraj Shrestha
AU  - Subita Neupane
AU  - Rameshwar Prasad Pokharel
PY  - 2026
DA  - 2026/05/26
JO  - African Journal of Paediatric Surgery
DO  - 10.67481/ajps.v19i2.1029
UR  - https://doi.org/10.67481/ajps.v19i2.1029
AB  - Background: Acute appendicitis is a common surgical emergency amongst the paediatric population. Available diagnostic tools are focussed to make a diagnosis of acute appendicitis. Adefinitive predictive factor for the diagnosis of complicated appendicitis is lacking. Thus, this aims to analyse hyperbilirubinaemia as a predictor of complicated appendicitis amongst the paediatric population. Materials and Methods: Aprospective observational study was conducted in a tertiary hospital from November 2018 to October 2019. All children undergoing emergency appendectomy were included in the study. Preoperatively, patients were evaluated clinically, and routine investigations including total and direct serum bilirubin were sent. All patients were grouped as ‘simple appendicitis’ or ‘complicated appendicitis’ based on intra‑operative and histological findings. Bilirubin level was compared between these groups and analysed. Results: A total of 52 children fulfilling the inclusion criteria were included. The mean age was 13.2 ± 4.2 years, and the male: female ratio was 2.1:1. Thirty‑four (65.4%) had simple appendicitis and 18 (34.6%) had complicated appendicitis. Total bilirubin was 23.83 ± 5.94 mmol/L in the complicated appendicitis group and 13.15 ± 3.29 mmol/L in the simple appendicitis group. Direct bilirubin was 5.28 ± 2.22 mmol/L in complicated appendicitis and 2.62 ± 0.83 mmol/L in simple one. Both total and direct bilirubin were significantly high in the complicated group (P < 0.001) compared to the simple appendicitis group. On the Receiver operating curve (ROC), the best cutoff value for total and direct bilirubin was 21 and 5.5 mmol/L, respectively. The sensitivity and specificity of total and direct bilirubin were 72.2%, 100%, and 61.1%, and 85.3%, respectively. Conclusion: It is concluded that hyperbilirubinaemia is a good predictor for paediatric complicated appendicitis.
SN  - 0189-6725
SN  - 0974-5998
ER  -