Concluded Case

This young male patient who presented with severe abdominal pain and vomiting had raised Serum Bilirubin of1.8mg ,was operated as an emergency for acute appendicitis, patient improved postoperatively. What could be the cause of jaundice.

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Concluded answer

It is acute appendicitis . Appended seems to be highly inflamed and swollen, removal ( appendicectomy) is only the treatment.

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It is mild jaundice. Causes could be 1.Severe E.Coli infection with hepatotoxic effect 2.Could be in severely inflamed necrosed appendix 3.May be a case of Gilbert's disease with acute appendicitis

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What is the total count and LFT. Associated Gilbert's disease with acute appendicitis could give this picture

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It is acute appendicitis . Appended seems to be highly inflamed and swollen, removal ( appendicectomy) is only the treatment.

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May possible in necrotising appendicitis Or may be hepatitis asoceated

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It is Acute Appendicitis.Incresed serum bilirubin is increased it could be due to inflammation & infection resulting in septecemia.

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Cause of hyperbilirubinaemia is due to E. coli infection in this case which deconjugate the bilirubin via portal vein go to the liver. There are many papers regarding this. One of my junior have thesis on this topic. Sir, you can follow this in next patient, do the preop LFT in suspected case of impending perforation of appendix.

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High bilirubin in case appedicitis is the predictor of either gangrenous or perforation of appendix.

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This is a case of acute appendicitis.the jaundice is of infective origin.

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Jaundice is due to Appendicitis withsevere sepsis & thrombo phlebitis.

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