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Forum Name: Liver Diseases

Question: Can ruptured appendix cause elevated liver enzymes


 Ruthiejb - Wed Aug 27, 2008 4:27 pm

After several days of abdominal pain, my husband went to our doctor who took blood and sent him for a cat scan. The cat scan showed he had appendicitis, and he was told to go to the hospital where he underwent surgery that night. The surgeon said the appendix had ruptured and when I asked him when, he said it could have been days ago. We just received the results of the blood test from that day and my husband's SGPT was 158. He's always had mildly elevated SGPT but never that high. Could the ruptured appendix have caused the elevation? The doctor told him to stop his zocor for a month to see if that affects the number. Thank you very much for your assistance.
 John Kenyon, CNA - Tue Sep 23, 2008 9:55 pm

User avatar Hello -

A ruptured appendix with no clearly recognized time of rupture can cause peritonitis or even sepsis, either of which, in turn, could cause major illness and other serious problems. That your husband didn't develop either of these to any significant extent is remarkable with free toxins at large inside the peritonium. However, there could have been enough contamination that the liver may have sustained some mild inflammation (this is only a guess). This, especially in conjunction with the regular use of Zocor (which has the potential to raise SGPT levels on its own) could account for the unusually high count. Staying off the Zocor for two weeks seems like a prudent move right now. Your husband will be retested after that "holiday" from the drug and a lot more will be clear at that time. Apparently your husband is a pretty hardy fellow to have got through the rupture of his appendix with nothing more than this having happend.

I hope this is helpful. Please do follow up with us.
 Dr. Tamer Fouad - Sat Oct 25, 2008 4:11 pm

User avatar I agree with John. It is rather remarkable. I hope your husband is doing well.
 Ruthiejb - Sat Oct 25, 2008 7:53 pm

Thank you both for your replies. My husband is doing well; the surgeon told him that his body had walled off the area of the ruptured appendix and had formed an abscess. It has been 7 weeks since the surgery and he is scheduled for a colonoscopy next week (this is his first....he is 51 years old). His last blood test showed normal liver enzymes which I'm relieved about, however, his last two blood tests showed low iron (38 the day before surgery and 41 a month later) and elevated CRP (5.1) a month after the surgery. The surgeon told us that the inflammation appeared to have come from outside the appendix which is atypical. I am very nervous about the colonoscopy, however, my husband says he feels good; he has not lost any weight (in fact he needs to but I'm relieved that his hasn't lost any since he hasn't been trying), and he has not had pain or unusual digestive or bowel issues since the surgery. I'm hoping nothing serious is going on with him based on what the surgeon said and his blood results. We should know more after the colonoscopy. Thank you again.
 John Kenyon, CNA - Mon Oct 27, 2008 9:12 pm

User avatar Hello again -

Good news all around. While the circumstances are somewhat unusual, these things do happen. The colonoscopy should be uneventful since it will barely reach the location of the former appendix so should pose no danger of perforation. It's also important to check and see if there are any other inflamed areas where something similar could be developing, so as to head that off. It's unlikely, but better to know things are all in order.

Otherwise your husband seems to be thriving despite all the fuss, so it is a very upbeat report. Thanks for the update and we'll be looking forward to hearing what, if anything, is learned from the colonoscopy.

Continued good luck to you both.
 Ruthiejb - Thu Oct 30, 2008 11:34 am

Thank you for your support, Dr. Kenyon. My husband had the colonoscopy this morning. The doctor found mild diverticulosis and a lipomatous swelling on the cecal tip, which he biopsied (he said he's not worried); no polyps. We're all very relieved since we had read that appendicitis past the age of 40 may indicate a simulaneous colon cancer (a little knowledge can be a dangerous thing). There still is the issue of his low iron which showed on two consecutive blood tests, one the day before surgery (38 ug/dL) and one a month after surgery (41 ug/dL). Could ruptured appendix cause a drop in iron?

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