Publication:

Role of liver function tests to assess severity of acute appendicitis and predict complications

Background Acute appendicitis is commonest surgical emergencies of abdomen. Literature shows LFT can be used as a marker of acute appendicitis and may predict severity of appendicitis.

Methods An observational prospective study of 100 cases of acute appendicitis. Study period was from October 2018 to September 2020. Ethical clearance certificate was taken from Institutional ethics Committee. All patients underwent abdominal ultrasound, blood tests including LFT and appendectomy. Histopathology reports were analysed. Patients were divided into 2 groups- inflammatory and complicated appendicitis. Data was collected and statistically analysed using SPSS software version 19.

Results Out of 100 patients 64% are males and 36% females. 4% are negative appendectomies. Total bilirubin elevated in 60% of inflammatory and 89% of complicated appendicitis, p value=0.0053 (significant), sensitivity- 62%. Direct bilirubin elevated in 88% of inflammatory and 96% of complicated appendicitis, p value=0.05 (significant), sensitivity-69%. ALT, AST not raised in both groups. ALP elevated in 81% of inflammatory and 82% of complicated appendicitis with sensitivity-70.5%.

Conclusions LFT can be used to diagnose, assess severity and predict complications of acute appendicitis with elevations of total bilirubin, direct bilirubin and ALP being most useful.