Abstract
Objective: To study the relationship between hyperbilirubinemia and acute appendicitis and to evaluate its credibility as a diagnostic marker for acute appendicitis and to evaluate whether elevated serum total bilirubin levels have a predictive potential for the diagnosis of complicated appendicitis
Background: In acute appendicitis occurs through bacterial invasion in appendix leads to transmigration of bacteria and release of TNF-alpha, IL6 and cytokines. These reach the liver through superior mesenteric vein and may produce inflammation or dysfunction of liver either directly or indirectly by altering hepatic blood flow with rising of total serum bilirubin.
Methods: This is a prospective cohort study including Ninety four (94) of adult patients have right iliac fossa pain attending to the Emergency Department (ED) at Suez Canal university Hospital. All 94 patients undergo total serum bilirubin measuring and post-operative histopathological examination of removed appendix.
Results: In this study population of 94 patients and found that thirty-six male patient (38 %) and fifty-eight female patient (62 %), 81 patients (86.2%) were diagnosed as acute appendicitis while 13 patients (13.8%) were normal post-operatively by histopathological reports. Amongst the patients diagnosed with Acute appendicitis post-operatively, 57 patients (70.4%) were found to have elevated serum total bilirubin (>1.2mg/dL) while 24 patients (29.6%) had normal serum total bilirubin levels (≤1.2 mg/dL).
Conclusion: Serum total bilirubin level appears to be a promising new laboratory marker for diagnosing acute appendicitis and have a predictive potential for the diagnosis of complicated appendicitis.

Key words: serum total bilirubin, acute appendicitis