Muhammad Khurram Zia, Muhammad Saad Usmani, Alvia Saad, Khatijatul Uzma.
Delayed Postoperative Recovery in patients of Acute Appendicitis with Hyperbilirubinemia.
Pak J Surg Jan ;31(3):191-5.

Objective: To determine the delayed postoperative recovery in patients of Acute Appendicitis with Hyperbilirubinemia. Method: A prospective descriptive study was conducted at Abbasi Shaheed hospital, Karachi from August 2010 to August 2013. All patients of age over 20 years of either gender presenting with signs and symptoms of appendicitis were included. Patients with appendicular lump, pregnancy, normal appendix, Diabetes mellitus, any cardiovascular disorder or respiratory disorder and bleeding disorders were excluded. Peroperative and histopathologic fi ndings were correlated with laboratory results and duration of hospital stay. Result: Out of 85 patients enrolled the mean age of the patients was 29 yrs. Th ere were 48 males and 37 females. Th ere were 57(67.1%) patients with acute appendicitis, 11(12.9%) with gangrenous appendicitis, 15(17.6%) with perforated appendix and 2(2.4%) with periappendicular abscess . Th e raised bilirubin was found in 29 (34.1%). Th e perforated appendix has highest levels of bilirubin found up to 3.1-3.5 mg/dl with statistically signifi cant value (p value 0.000). Th e mean duration of hospital stay was 2.6 ± 1.68 days. Th e patients with gangrenous appendicitis and perforated appendix required admission for 4 or more than 4 days with statistical signifi cant value found with hyperbilirubinemia. Conclusion: Increased hospital stay was associated with complicated appendicitis and raised bilirubin levels. Early diagnosis is important in order to prevent delay in surgical intervention and thus morbidity and mortality

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