Annals of Coloproctology

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Hyperbilirubinemia Is a Significant Indicator for the Severity of Acute Appendicitis: Young Ran Hong, Chul-Woon Chung, Jong Woo Kim, Chang Il Kwon, Dae Ho Ahn, Sung Won Kwon, Seong Ki Kim; J Korean Soc Coloproctol. 2012;28(5):247-252. Published online October 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.5.247

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28 Citations

Purpose

This study aims to reveal more effective clinical or laboratory markers for the diagnosis of acute appendicitis and to score the severity based on a sufficiently large number of patients with acute appendicitis.

Methods

We identified 1,195 patients with acute appendicitis after excluding those with other causes of hyperbilirubinemia among the 1,271 patients that underwent a laparoscopic or an open appendectomy between 2009 and 2010. A retrospective chart review of the medical records, including laboratory and histologic results, was conducted. We then analyzed the data using univariate and multivariate analyses.

Results

Among the 1,195 patients, a laparoscopic appendectomy was performed in 685 cases (57.32%), and an open appendectomy was performed in 510 cases (42.68%). The univariate analysis demonstrated significant differences for white blood cell count (P < 0.0001), segmented neutrophils (P = 0.0035), total bilirubin (P < 0.0001), and systemic inflammatory response syndrome (SIRS) score between groups (P < 0.0001). The multivariate analysis demonstrated that total bilirubin (odds ratio, 1.772; 95% confidence interval, 1.320 to 2.379; P = 0.0001) and SIRS score (odds ratio, 1.583; 95% confidence interval, 1.313 to 1.908; P < 0.0001) have statistically significant diagnostic value for perforated appendicitis.

Conclusion

Hyperbilirubinemia is a statistically significant diagnostic marker for acute appendicitis and the likelihood of perforation.

Citations

Citations to this article as recorded by

Hyperbilirubinemia and acute appendicitis: a cohort study
Harris BARTIMEUS, Ibrahim LABEDA, Julianus A. UWURATUW, Joko HENDARTO, Prihantono PRIHANTONO, Muhammad I. KUSUMA, Muhammad FARUK
Chirurgia.2025;[Epub] CrossRef
Role of immature granulocyte and blood biomarkers in predicting perforated acute appendicitis using machine learning model
Zeynep Kucukakcali, Sami Akbulut
World Journal of Clinical Cases.2025;[Epub] CrossRef
Hyperbilirubinemia as a Marker for Complicated Acute Appendicitis: A Systematic Review
Alicja Czyszczon, Bartosz Maczkowski, Aneta Tkaczyk, Marek Drozdz, Wiktoria Boral, Szymon Mikler, Magdalena Mandyna, Aleksandra Przelaskowska, Jan Pulinski
Cureus.2025;[Epub] CrossRef
Diagnostic Value of Hematological and Biochemical Markers in Pediatric Appendicitis: A ROC-Based Retrospective Evaluation
Sevgi Buyukbese Sarsu
Medical Bulletin of Haseki.2025; 63(5): 236. CrossRef
Diagnostic Accuracy of Ultrasound for Acute Appendicitis Compared with Histopathological Findings
Faraj A. Aljali, Fathi A. Abdalla Asnini
Tobruk University Journal of Medical Sciences.2025; 9(2): 21. CrossRef
Diagnostic value of laboratory parameters for complicated appendicitis: A two‑center study
Qian Zhang, Hongwei Zhao, Fangli Wang, Wenqiang Li, Peng Zhang
Biomedical Reports.2024;[Epub] CrossRef
Letter to the Editor regarding “A novel Appendicitis TriMOdal prediction Score (ATMOS) for acute appendicitis in pregnancy: a retrospective observational study”
Rıfat Peksöz, Ferdi Cambaztepe, Sabri Selçuk Atamanalp
Updates in Surgery.2023; 75(1): 265. CrossRef
Individual biomarkers in the blood are not yet applicable in diagnosing complicated appendicitis: A scoping review
Binyamin Sikander, Jacob Rosenberg, Siv Fonnes
The American Journal of Emergency Medicine.2023; 67: 100. CrossRef
Elevated total and direct bilirubin are associated with acute complicated appendicitis: a single-center based study in Saudi Arabia
Mohammed S. Alfehaid, Ayman M. Babiker, Abdullah Hamad Alkharraz, Hamad yousef Alsaeed, Ali Abdullah Alzunaydi, Adi Abdulaziz Aldubaiyan, Hanan Abdalla Sinyan, Bshayr K. Alkhalaf, Rakan Alshuwaykan, Rehana Khalil, Osama Al-Wutayd
BMC Surgery.2023;[Epub] CrossRef
Significance of laboratory parameters in diagnosing acute appendicitis during pregnancy
Rıfat Peksöz, Esra Dişçi, Abdulkadir Kaya, Enes Ağırman, Ercan Korkut, Nurhak Aksungur, Necip Altundaş, Salih Kara, Sabri Selçuk Atamanalp
ANZ Journal of Surgery.2022; 92(1-2): 121. CrossRef
Hyperbilirubinemia and Hyponatremia as Predictors of Complicated Appendicitis
Abdullah Shuaib, Nour Alhamdan, Husain Arian, Mohamed Alaa Sallam, Ali Shuaib
Medical Sciences.2022; 10(3): 36. CrossRef
Evaluation of role of hyperbilirubinemia as a new diagnostic marker of complicated appendicitis
Sabyasachi Bakshi, Nilay Mandal
BMC Gastroenterology.2021;[Epub] CrossRef
Clinical predictors of gangrenous appendicitis: elevated total bilirubin level and computed tomography scan findings
Itsuki Naya, Kensuke Adachi, Koichi Takeuchi, Yuno Ariyama, Akihiro Hosaka, Kazuhiro Imamura, Yasuhiro Morita, Shigeki Matsubara, Alan Kawarai Lefor, Hisanaga Horie
Acute Medicine & Surgery.2021;[Epub] CrossRef
THE UTILITY OF SERUM BILIRUBIN AS A MARKER IN ACUTE ABDOMEN
P N Sreeramulu, Shashidhar K N, Varsha A
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH.2021; : 16. CrossRef
Acute Appendicitis in the Elderly: A Literature Review on an Increasingly Frequent Surgical Problem
Sintija Lapsa, Arturs Ozolins, Ilze Strumfa, Janis Gardovskis
Geriatrics.2021; 6(3): 93. CrossRef
Obstructive-Type Jaundice without Bile Duct Dilatation in Generalized Peritonitis Is a Specific Sign of Spontaneous Gall Bladder Perforation
Vicky Sumarki Budipramana, Maria Meilita
Case Reports in Medicine.2020; 2020: 1. CrossRef
Diagnostic accuracy of procalcitonin for overall and complicated acute appendicitis in children: a meta-analysis
Wei Cui, Haipeng Liu, Hong Ni, Xianhui Qin, Liran Zhu
Italian Journal of Pediatrics.2019;[Epub] CrossRef
A Prospective Study to Evaluate the Role of Serum Bilirubin in Acute Appendicitis
Siva Kumar Puligundla, Gandikota Venkata Prakash, Ajay Babu, Boddukura Sahithi Priya, Sreedhar Sreedhar, Anugna Anugna, Sumesh Raja, Tejaswi S.
Journal of Evidence Based Medicine and Healthcare.2019; 6(48): 3039. CrossRef
Evaluation of Serum Bilirubin as a Predictive Marker for Simple and Complicated Appendicitis in Sulaimani Emergency Teaching Hospital
Seerwan Hama Shareef, Dara Ahmed Mohammed, Goran Ameer Ahmed
Kurdistan Journal of Applied Research.2018; : 15. CrossRef
Lack of utility of measuring serum bilirubin concentration in distinguishing perforation status of pediatric appendicitis
William Bonadio, Santina Bruno, David Attaway, Logesh Dharmar, Derek Tam, Peter Homel
The American Journal of Emergency Medicine.2017; 35(6): 885. CrossRef
Hyperbilirubinaemia: its utility in non‐perforated appendicitis
Anna Sandstrom, David A. Grieve
ANZ Journal of Surgery.2017; 87(7-8): 587. CrossRef
Biomarkers of acute appendicitis: systematic review and cost–benefit trade-off analysis
Amish Acharya, Sheraz R. Markar, Melody Ni, George B. Hanna
Surgical Endoscopy.2017; 31(3): 1022. CrossRef
Hyperbilirubinaemia alone cannot distinguish a perforation in acute appendicitis
Fábio R. Silva, Maria Inês da Rosa, Bruno R. Silva, Carla Simon, Maria Cecília Alexandre, Lidia R. Medeiros, Fabrício S. Bitencourt, Maria Eduarda Fernandes dos Reis
ANZ Journal of Surgery.2016; 86(4): 255. CrossRef
Predictive value of abnormally raised serum bilirubin in acute appendicitis: A cohort study
A.C. Chambers, S.L. Bismohun, H. Davies, P. White, A.V. Patil
International Journal of Surgery.2015; 13: 207. CrossRef
Diagnostic markers in acute appendicitis
Yahya A. Al-Abed, Nasser Alobaid, Fiona Myint
The American Journal of Surgery.2015; 209(6): 1043. CrossRef
Diagnostic accuracy of hyperbilirubinaemia in anticipating appendicitis and its severity
Sven Muller, Claudius Falch, Steffen Axt, Peter Wilhelm, Dirk Hein, Alfred Königsrainer, Andreas Kirschniak
Emergency Medicine Journal.2015; 32(9): 698. CrossRef
Serum total bilirubin elevation is a predictor of the clinicopathological severity of acute appendicitis
Satoshi Nomura, Masanori Watanabe, Osamu Komine, Takeshi Shioya, Tetsutaka Toyoda, Hideki Bou, Tetsuo Shibuya, Hideyuki Suzuki, Eiji Uchida
Surgery Today.2014; 44(6): 1104. CrossRef
Elevated serum bilirubin in assessing the likelihood of perforation in acute appendicitis: A diagnostic meta-analysis
Salvatore Giordano, Markus Pääkkönen, Paulina Salminen, Juha M. Grönroos
International Journal of Surgery.2013; 11(9): 795. CrossRef

Clinical Characteristics of Ischemic Colitis According to Location: Ho Jin Chang, Chul Woon Chung, Kwang Hyun Ko, Jong Woo Kim; J Korean Soc Coloproctol. 2011;27(6):282-286. Published online December 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.6.282

6,101 View
43 Download
11 Citations

Abstract PDF

Purpose

The aim of this study was to analyze various clinical characteristics of ischemic colitis according to its location.

Methods

The medical records of 92 cases of gastrointestinal ischemic colitis (IC) diagnosed at Bundang CHA Hospital from 1995 to 2008 were reviewed and analyzed retrospectively. The patients were diagnosed by using colonoscopic biopsies or laparotomy findings. The patients were divided into two groups, right and left, according to the main involvement area of the IC at the embryologic boundary line of the distal transverse colon, and the two groups were compared as to clinical characteristics and co-morbid diseases.

Results

Left IC was present in 59 patients (64.1%) and right IC in 33 patients (35.9%). No differences between the two groups in terms of clinical characteristics, cardiovascular disease and diabetes mellitus were observed. However, in 16 cases with renal failure, 10 patient had right IC and 6 patients had left IC, and this difference had statistical significance (P = 0.014). Among the 16, the 11 patients requiring hemodialysis included 8 with right IC (24.2%) and 3 with left IC (5.1%; P = 0.009). Among the 19 cases of severe IC requiring surgical treatment or involving mortality, irrespective of surgery, 11 patients showed right IC and 8 patients showed left IC (P = 0.024).

Conclusion

Right-side ischemic colitis was significantly associated with renal failure and disease severity, so patients with right-side colon ischemia should be more carefully observed and managed.

Citations

Citations to this article as recorded by

Ischemic Colitis in a Young Female Following Herbal Supplement Ingestion
Lorraine I Chong Tai, Syed Ahmed, Rajiv R Chokshi
Cureus.2023;[Epub] CrossRef
Colitis isquémica. ¿La localización en el colon derecho tiene peor pronóstico?
Vincenzo Vigorita, Marta Paniagua García-Señoráns, Gianluca Pellino, Paula Troncoso Pereira, Alberto de San Ildefonso Pereira, Enrique Moncada Iribarren, Raquel Sánchez-Santos, Jose Enrique Casal Núñez
Cirugía Española.2022; 100(2): 74. CrossRef
Ischemic colitis. Does right colon location mean worst prognosis?
Vincenzo Vigorita, Marta Paniagua García-Señoráns, Gianluca Pellino, Paula Troncoso Pereira, Alberto de San Ildefonso Pereira, Enrique Moncada Iribarren, Raquel Sánchez-Santos, Jose Enrique Casal Núñez
Cirugía Española (English Edition).2022; 100(2): 74. CrossRef
Real‐world multicentre experience of the pathological features of colonic ischaemia and their relationship to symptom duration, disease distribution and clinical outcome
M. Fenster, P. Feuerstadt, L. J. Brandt, M. S. Mansoor, T. Huisman, O. C. Aroniadis
Colorectal Disease.2018; 20(12): 1132. CrossRef
Colonic ischemia
Ayah Oglat, Eamonn M.M. Quigley
Current Opinion in Gastroenterology.2017; 33(1): 34. CrossRef
The predictors of the severity of ischaemic colitis: a systematic review of 2823 patients from 22 studies
D. Sun, C. Wang, L. Yang, M. Liu, F. Chen
Colorectal Disease.2016; 18(10): 949. CrossRef
ACG Clinical Guideline: Epidemiology, Risk Factors, Patterns of Presentation, Diagnosis, and Management of Colon Ischemia (CI)
Lawrence J Brandt, Paul Feuerstadt, George F Longstreth, Scott J Boley
American Journal of Gastroenterology.2015; 110(1): 18. CrossRef
Ischemic colitis: spectrum of CT findings, sites of involvement and severity
Cinthia Cruz, Hani H. Abujudeh, Rosalynn M. Nazarian, James H. Thrall
Emergency Radiology.2015; 22(4): 357. CrossRef
CT Findings in Acute, Subacute, and Chronic Ischemic Colitis: Suggestions for Diagnosis
Francesca Iacobellis, Daniela Berritto, Dominik Fleischmann, Giuliano Gagliardi, Antonio Brillantino, Maria Antonietta Mazzei, Roberto Grassi
BioMed Research International.2014; 2014: 1. CrossRef
Intestinal Ischemia: US-CT findings correlations
A Reginelli, EA Genovese, S Cappabianca, F Iacobellis, D Berritto, P Fonio, F Coppolino, R Grassi
Critical Ultrasound Journal.2013;[Epub] CrossRef
Severe hyperkalemia following colon diversion surgery in a patient undergoing chronic hemodialysis: a case report
Nina Kononowa, Michael J Dickenmann, Min Jeong Kim
Journal of Medical Case Reports.2013;[Epub] CrossRef

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