Introduction: Acute Appendicitis is the most common general surgical emergency and early surgical intervention improves outcomes. Despite the increased use of ultrasonography, computed tomography scanning and laparoscopy, the rate of misdiagnosis of appendicitis has remained constant (15.3%) and the rate of appendicular perforation. In an age, accustomed to early and accurate preoperative diagnosis, acute appendicitis remains an enigmatic challenge and a reminder of the art of surgical diagnosis. This study was done to conclude whether the Serum Bilirubin can be considered as a new laboratory marker to aid in the diagnosis of acute appendicitis. Aims: To evaluate whether elevated Bilirubin level is important in predicting the diagnosis of acute appendicitis (simple and complicated appendicitis). Material and Methods: This retrospective study was conducted in the department of general surgery, Adichunchanagiri institute of medical sciences, B. G. Nagara, Mandya (D), from August 2018 to February 2020. A total of 100 patients with clinical diagnosis of acute appendicitis or appendicular perforation were studied. Results: In this study, males (68%) outnumbered females (32%) and overall mean age was 27±9.58 years. Of the 100 patients, 71% were confirmed as acute appendicitis while 29% were diagnosed with appendicular perforation. Of 71 patients with acute appendicitis, 12.7% had raised bilirubin levels, while 87.3% had normal levels. Conclusion: This scoring system is practical and reliable diagnostic modality for the accuracy in diagnosis of acute appendicitis and to avoid negative appendicectomies.

Keywords: Pain abdomen; Acute Appendicitis; Appendicular perforation; Elevated Serum Bilirubin level; Negative Appendicectomy.