We read with interest the article by Emmanuel et al investigating the usefulness of hyperbilirubinaemia in the diagnosis of acute appendicitis. The pilot results of our research show similar findings but we have studied a greater number of patients (n=975), of which 892 patients (91.5%) had appendicitis. Bilirubin was raised in slightly fewer patients with acute appendicitis (22.4%) and in those with a non-inflamed appendix (5.26%) (p 21μmol/l.
Ultimately, our results correlate very well with those of Emmanuel et al and this contributes further weight to the use of bilirubin as a marker for acute appendicitis and the need to use this test in the assessment of acute appendicitis.