Role of liver function tests to assess severity of acute appendicitis and predict complications


  • Puli Vineela Department of General surgery, Kamineni Institute of Medical Sciences, Narketpally, Telangana, India
  • Nikhil Deshmukh Department of General surgery, Kamineni Institute of Medical Sciences, Narketpally, Telangana, India
  • Krishnamurthy Penugondla Department of General surgery, Kamineni Institute of Medical Sciences, Narketpally, Telangana, India



Appendicitis, LFT, Complications


Background: Acute appendicitis is commonest surgical emergencies of abdomen. Literature shows LFT can be used as a marker of acute appendicitis and may predict severity of appendicitis.

Methods: An observational prospective study of 100 cases of acute appendicitis. Study period was from October 2018 to September 2020. Ethical clearance certificate was taken from Institutional ethics Committee. All patients underwent abdominal ultrasound, blood tests including LFT and appendectomy. Histopathology reports were analysed. Patients were divided into 2 groups- inflammatory and complicated appendicitis. Data was collected and statistically analysed using SPSS software version 19.

Results: Out of 100 patients 64% are males and 36% females. 4% are negative appendectomies. Total bilirubin elevated in 60% of inflammatory and 89% of complicated appendicitis, p value=0.0053 (significant), sensitivity- 62%. Direct bilirubin elevated in 88% of inflammatory and 96% of complicated appendicitis, p value=0.05 (significant), sensitivity-69%. ALT, AST not raised in both groups. ALP elevated in 81% of inflammatory and 82% of complicated appendicitis with sensitivity-70.5%.

Conclusions: LFT can be used to diagnose, assess severity and predict complications of acute appendicitis with elevations of total bilirubin, direct bilirubin and ALP being most useful.



Geoffrey F, Bruce S, Traci LH. Appendix. In: Yeo CJ, eds. Shackelford’s Surgery of the Elementary Tract. 8th edn. Elsevier. 2018:1951-1964.

Wente MN, Waleczek H. Strategy for avoidance of negative appendectomies. Chirurg. 2009:80(7):588-953

Edino ST, Mohammed AZ, Orchicha O, Anumah M. Appendicitis in Kano, Nigeria 95 year review of Pattern, morbidity and mortality. Ann Afr Med. 2004;3:38-41.

Dhakal RR. When it was not Appendicitis- Retrospetive review of 392 appendectomies. J Gandaki Med Coll Nepal. 2010;l3(1):4-8.

Gilmore OJ, Browett JP, Griffin PH, Ross IK, Brodribb AJ, Cooke TJ, et al. Appendicitis and mimicking conditions: a prospective study. Lancet. 1975;306(7932):421-4.

Kalan M, Tabbot O, Cunlife WJ, Rich AJ. Evaluation of the modified alvrado score in the diagnosis of acute appendicitis. A prospective study. Ann Royal Coll Surg Engl. 1994;76:418-9.

Yadav S, Chandra K. Liver function test as a marker for acute appendicitis. Janaki Med Coll J Med Sci. 2015;3(1):31-6.

Emmanuel A, Murchan P, Wilson I, Balfe P. The value of hyperbilirubinemia in the diagnosis of acute appendicitis. Ann Royal Coll Surg Engl. 2011;93:213-7.

Khan S. Evaluation of hyperbilirubinemia in acute inflammation of appendix: a prospective study 45 cases. Kathmandu Univ Med J. 2006;4(3):281-9.

Sahm M, Pross M, Lippert H. Acute appendicitis- changes in epidemiology, diagnosis and therapy. Zentralbl Chir. 2011;136:18-24.

Mishra BM, Nayak MK, Mishra S, Sahu P, Das D. Role of liver function test parameters in acute appendicitis and its complication: a prospective study. Int Surg J. 2018;6(1):193-7.

Khan S. Effect of Acute appendicitis on routine Liver function Tests. J Inst Med. 2008;30:141-5.

Dieulafoy G. The appendiceal liver: abscesses of faith concise with appendicitis. Semin Med.1898;18:449.






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