Role of serum bilirubin as a marker of acute gangrenous appendicitis


  • P Ghimire Department of Surgery, Manipal College of Medical Sciences, Pokhara
  • P Thapa Department of Psychiatry, Manipal College of Medical Sciences, Pokhara
  • N Yogi National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu
  • P Ghimire Medical Officer, Emergency Department, Manipal Teaching Hospital, Pokhara



Serum total bilirubin, acute gangrenous appendicitis, Alvarado’s score


Background: This study has compared the difference in serum bilirubin between patients with gangrenous and non-gangrenous appendicitis.

Methods: A prospective analytical study of, 141 patients who underwent appendectomy, from March 2010 to March 2011 in Manipal Teaching Hospital, Pokhara, Nepal was carried out. Clinico-demographic data, Alvarado’s score, total serum bilirubin, total leucocyte count and histopathological report of all the cases were collected in a prestructured proforma. Comparison between gangrenous and non-gangrenous appendicitis groups was carried out using independent sample t test, Chisquare test, and direct logistic regression. The data was analyzed using SPSS 11.6 software.

Result: Around 43% (61 out of 141) patients had gangrenous appendicitis and statistically significant difference was found between the two groups in total Alvarado’s score, total count and total bilirubin level. The effect size as indicated by eta square statistics was large for total bilirubin (eta squared=0.39) as compared to total Alvarado’s score (0.09) and total leucocyte count (0.05). Direct logistic regression model showed serum total bilirubin as the only independent variable to make a unique statistically significant contribution in predicting gangrenous appendicitis.

Conclusion: Pre-operative assessment of serum total bilirubin can serve as an important maker of acute gangrenous appendicitis.


Nepal Journal of Medical Sciences. 2012;1(2): 89-92


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How to Cite

Ghimire, P., Thapa, P., Yogi, N., & Ghimire, P. (2012). Role of serum bilirubin as a marker of acute gangrenous appendicitis. Nepal Journal of Medical Sciences, 1(2), 89–92.



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