الفهرس 
? EmbryogenesisOnly 14 pages are availabe for public view
Abstract
Background: appendectomy is the far most common general surgical operation. However, it is not uncommon for surgeons to face difficulties in diagnosis of appendicitis, and also in determining the proper timing for surgery as appendicitis takes numerous clinical presentations ranging from slight abdominal pain up to more serious forms such as; bowel obstruction (specially in extremes of age), and frank peritonitis.
Aim of the Work: carrying out a prospective study; in which the primary outcome is assessing the relation between the serum bilirubin level and histologically proven acute appendicitis. Comparison between sensitivity and specificity of this novel marker and the well-established marker (WBCs) represents secondary outcomes.
Patients and Methods: all adult patients males and females aged from (18-60 yrs) presenting to emergency departments of the military hospitals in the duration from June 2013 to June 2015 who diagnosed as having acute appendicitis will be assessed for eligibility. Patients who have history of liver diseases, abnormal liver function tests, hemolytic blood diseases, congenital metabolic syndromes, congenital, & acquired biliary radicle diseases will be excluded from the study.
Results: according to WBCs count: the comparison between the five groups revealed a high statistically significant difference between groups according to WBCs (p-value <0.001). As the degree of inflammation of the appendix increases, the total white cell count increases. The sensitivity, specificity and positive predictive value of total cell count in our study were 68%, 66%, 66.7% respectively. The sensitivity, specificity, PPV, NPV of total serum bilirubin were 59%, 82% 76.3% 66.1% respectively.
Conclusion: there is no statistically significant difference between the five groups according to age, temperature, pulse and ALT. There is a high statistically significant difference between groups according to duration of symptoms, WBCs and bilirubin.