Publication:

A cross-sectional study on elevated levels of serum amylase as a predictive factor for appendiceal perforation in patients with acute appendicitis

Background Acute appendicitis is a common surgical emergency, and appendiceal perforation can lead to serious complications. Early identification of perforation is critical to improving outcomes. Serum amylase has been suggested as a potential marker for perforated appendicitis, but its diagnostic accuracy remains under-investigated. This study aimed to evaluate the diagnostic utility of elevated serum amylase levels as a predictive factor for appendiceal perforation in patients with acute appendicitis.

Methods An observational study was conducted at Hi-tech medical college and hospital, Bhubaneswar, from December 2023 to February 2025. Sixty-four patients diagnosed with acute appendicitis and undergoing appendectomy were included. Preoperative serum levels of amylase and lipase were measured. Postoperative histopathological examination confirmed the diagnosis of perforated or non-perforated appendicitis. Statistical analysis was performed using chi-square test, t-test, and ROC curve.

Results Among the 64 patients, 28 had perforated appendicitis, and 36 had non-perforated appendicitis. The mean serum amylase level was significantly higher in the perforated group (72.1±27.3 mg/dl) compared to the non-perforated group (30.1±11 mg/dl) (p<0.0001). No significant difference was observed between groups regarding serum lipase.

Conclusions Elevated serum amylase levels were associated with perforated appendicitis in patients with acute appendicitis. Serum amylase demonstrated high diagnostic accuracy and could serve as a predictive marker for appendiceal perforation. Further studies are warranted to validate these findings and explore the clinical utility of serum amylase in the early diagnosis of perforated appendicitis.