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Bilirubin as a Diagnostic Factor in Acute Appendicitis
Abdelrahman Elafandy1, Sandeep Singh1
1General Surgery, Warwick Hospital, Warwick, GBR.
Cureus
|November 4, 2025
Summary
Elevated bilirubin levels show high specificity in diagnosing acute appendicitis, aiding surgical decisions for right lower abdominal pain. This biomarker helps confirm appendicitis, preventing delayed treatment and potential complications.
Area of Science:
- Medical Diagnostics
- Surgical Emergencies
Background:
- Acute appendicitis is a frequent surgical emergency.
- Diagnostic challenges exist, particularly in young females.
- Current diagnostic tools include White Blood Cell (WBC) count, C-reactive protein (CRP), and fever.
Purpose of the Study:
- To investigate the utility of bilirubin as a diagnostic marker for acute appendicitis.
- To assess if bilirubin levels can aid in surgical decision-making for acute appendicitis.
Main Methods:
- Retrospective observational study.
- Inclusion of patients presenting with acute right lower abdominal pain.
- Data analysis of patient records from Warwick Hospital's general surgery on-call service (January-May 2024).
Main Results:
- 360 patients were analyzed; 103 underwent appendectomy.
- 36 patients (10%) presented with hyperbilirubinemia.
- Hyperbilirubinemia was observed in 26 patients (72.2%) who had an appendectomy.
- Bilirubin demonstrated a specificity of 96.2% and a sensitivity of 27.7% for acute appendicitis diagnosis.
Conclusions:
- Bilirubin is a highly specific indicator for diagnosing acute appendicitis.
- Elevated bilirubin can support surgical decisions in cases of acute right lower abdominal pain.
- Utilizing bilirubin may help prevent complications associated with delayed surgical management.
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