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Published in: Surgery Today 6/2014

01-06-2014 | Original Article

Serum total bilirubin elevation is a predictor of the clinicopathological severity of acute appendicitis

Authors: Satoshi Nomura, Masanori Watanabe, Osamu Komine, Takeshi Shioya, Tetsutaka Toyoda, Hideki Bou, Tetsuo Shibuya, Hideyuki Suzuki, Eiji Uchida

Published in: Surgery Today | Issue 6/2014

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Abstract

Purpose

Elevation of the serum total bilirubin (STB) level not stemming from hepatic dysfunction or biliary obstruction may be seen in cases of acute appendicitis. This paper deals with the clinical significance of such elevations.

Methods

Data from 410 appendectomized patients classified into two groups (a high preoperative STB group and a normal preoperative STB group) were analyzed to reveal the significance of preoperative hyperbilirubinemia. We also examined whether the preoperative STB level might serve as a risk factor for gangrenous appendicitis by a multivariate analysis.

Results

Gangrenous appendicitis was more common in the high preoperative STB group (p < 0.001). The multivariate analysis revealed that an elevated preoperative STB level (odds ratio 1.7919) was a risk factor for gangrenous appendicitis.

Conclusion

In patients with an elevated preoperative STB level, it is very likely that the inflammation is severe and that the disease has progressed to a severe condition histopathologically; therefore, meticulous attention should be paid to the selection of the surgical procedure, as well as to the postoperative clinical course.
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Metadata
Title
Serum total bilirubin elevation is a predictor of the clinicopathological severity of acute appendicitis
Authors
Satoshi Nomura
Masanori Watanabe
Osamu Komine
Takeshi Shioya
Tetsutaka Toyoda
Hideki Bou
Tetsuo Shibuya
Hideyuki Suzuki
Eiji Uchida
Publication date
01-06-2014
Publisher
Springer Japan
Published in
Surgery Today / Issue 6/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-013-0659-5

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