{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:41:26Z","timestamp":1791808886854,"version":"4.3.4"},"reference-count":33,"publisher":"Royal College of Surgeons of England","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["annals"],"published-print":{"date-parts":[[2011,4]]},"abstract":"<jats:sec><jats:title>INTRODUCTION<\/jats:title><jats:p> No reliably specific marker for acute appendicitis has been identified. Although recent studies have shown hyperbilirubinaemia to be a useful predictor of appendiceal perforation, they did not focus on the value of bilirubin as a marker for acute appendicitis. The aim of this study was to determine the value of hyperbilirubinaemia as a marker for acute appendicitis. <\/jats:p><\/jats:sec><jats:sec><jats:title>MATERIALS AND METHODS<\/jats:title><jats:p> A retrospective analysis of appendicectomies performed in two hospitals (n=472). Data collected included laboratory and histological results. Patients were grouped according to histology findings and comparisons were made between the groups. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> The mean bilirubin levels were higher for patients with simple appendicitis compared to those with a non-inflamed appendix (p&lt;0.001). More patients with simple appendicitis had hyperbilirubinaemia on admission (30% vs 12%) and the odds of these patients having appendicitis were over three times higher (odds ratio: 3.25, p&lt;0.001). Hyperbilirubinaemia had a specificity of 88% and a positive predictive value of 91% for acute appendicitis. Patients with appendicitis who had a perforated or gangrenous appendix had higher mean bilirubin levels (p=0.01) and were more likely to have hyperbilirubinaemia (p&lt;0.001). The specificity of hyperbilirubinaemia for perforation or gangrene was 70%. The specificities of white cell count and C-reactive protein were less than hyperbilirubinaemia for simple appendicitis (60% and 72%) and perforated or gangrenous appendicitis (19% and 36%). <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p> Hyperbilirubinaemia is a valuable marker for acute appendicitis. Patients with hyperbilirubinaemia are also more likely to have appendiceal perforation or gangrene. Bilirubin should be included in the assessment of patients with suspected appendicitis. <\/jats:p><\/jats:sec>","DOI":"10.1308\/147870811x566402","type":"journal-article","created":{"date-parts":[[2011,4,4]],"date-time":"2011-04-04T16:27:32Z","timestamp":1301934452000},"page":"213-217","source":"Crossref","is-referenced-by-count":58,"title":["The value of hyperbilirubinaemia in the diagnosis of acute appendicitis"],"prefix":"10.1308","volume":"93","author":[{"given":"Andrew","family":"Emmanuel","sequence":"first","affiliation":[{"name":"Department of Surgery, St Luke's Hospital Kilkenny, Ireland"},{"name":"Department of Surgery, South Tipperary General Hospital Clonmel, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Murchan","sequence":"additional","affiliation":[{"name":"Department of Surgery, South Tipperary General Hospital Clonmel, 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