Q: Which of the following liver function test is described as a marker of appendiceal perforation?
A) Alanine transaminase (ALT)
B) Aspartate transaminase (AST)
C) Alkaline phosphatase (ALP)
D) Gamma-glutamyl transpeptidase (GGT)
E) Total bilirubin (TB)
Answer: E
Although elevation of total serum bilirubin stays mild around >1.0 mg/dL but if present in patients with acute appendicitis, the sensitivity for appendiceal perforation is 70 percent and specificity is 86 percent. It is a good adjuvant marker to help in deciding the emergency of the situation.
#surgicalcriticalcare
#hepatology
Reference:
Sand M, Bechara FG, Holland-Letz T, et al. Diagnostic value of hyperbilirubinemia as a predictive factor for appendiceal perforation in acute appendicitis. Am J Surg 2009; 198:193.
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