Evaluating Efficacy, Specificity, and Sensitivity of Liver Enzymes Levels for Early Diagnosis of Acute Appendicitis and its Complications

The most common etiology for patients with acute abdominal pain presenting in emergency departments is acute appendicitis. This study aimed to evaluate the effectiveness of liver enzymes in early diagnosis of acute appendicitis and prediction of its complications. 176 patients with the chief complaint of abdominal pain presented in the emergency departments were enrolled in this study. All included patients underwent standard approach for acute abdomen with target focus for appendicitis. Samples for serum levels of ALT and AST on arrival have been arranged for all included. Patients were evaluated for appendicitis and diagnosis confirmed by histopathology. AST, ALT variables and confirmed diagnosis of acute appendicitis, and related complications have been evaluated for any correlations using Kruskal-Wallis test. Based on the results, 67 simple, 24 complicated appendicitis, and 85 cases of normal appendix were evaluated. The mean AST was significantly different in normal, simple appendicitis, and complicated groups (p=0.019), but the mean ALT failed to show a significant difference. The differential test showed that there was a significant difference between the two appendicitis groups and the normal group in AST (p<0.05), but not between the two appendicitis groups. The p-values of AST and ALT were 0.17 and 0.2, respectively.  According to the results of this study, it seems that increased AST may be increased in simple/complicated appendicitis in contrast to normal group, but regarding AUC curve data, AST and ALT fail to have the necessary diagnostic accuracy and efficiency to diagnose acute appendicitis and predict its complications.