EFFECT OF ACUTE APPENDICITIS AND ITS COMPLICATIONS ON THE PARAMETERS OF LIVER FUNCTION TESTS

Abstract

BACKGROUND AND OBJECTIVES: Acute appendicitis is one of the most common surgical conditions encountered by the surgeons worldwide. In acute appendicitis, liver function test is one of the biochemical tests used to predict the severity of disease process. Blood from the abdominal organs reaches the liver via portal vein which not only carries the nutrients but also bacteria and toxins absorbed from the gut. When the load is more than the functional capacity of the liver, it leads to parenchymal damage to the liver, which is reflected as deranged parameters of liver function tests. The present study has been designed to evaluate the effect of acute appendicitis and its complications on liver function tests. MATERIAL AND METHOD: This observational prospective study was conducted on 55 cases of acute appendicitis and its complications. Patients of all ages and of either sex presenting with acute appendicitis (ALVARADO score >9 and confirmed by USG) were included in the study and were subjected to Liver function tests (LFT) and histopathology examination report were collected after appendicectomy. RESULTS: On histopathological and intraoperative examination, 5.45% had normal appendix, 54.54% had inflamed appendix, 40% had gangrenous or perforated appendix. Liver function tests were evaluated in these subjects. We found that in subjects with inflamed appendix, 16.6%, 10% and 6.6% had elevated levels of total bilirubin, AST, ALT respectively and none had elevated ALP. Similarly, in subjects with perforated/gangrenous appendix, 72.7%, 54.5%, 18.2% and 9.1% had elevated total bilirubin, AST, ALT and ALP levels respectively. The LFT parameters are deranged in pathological appendix and more specifically the total bilirubin level is high for gangrenous and perforated appendix. CONCLUSION: LFT parameters are deranged in complicated appendicitis and more specifically the total bilirubin level.