التفاصيل البيبلوغرافية
| العنوان: |
A Prospective Study on Serum Lactate For Early Prediction of Strangulation in Intestinal Obstruction in A Single Institution. |
| المؤلفون: |
Kanhar, Manabhanjan Bhimasingh1, Meher, Roshan Kumar2, Sahoo, Kumuda Bandhu3, Mohapatra, Abinasha4 |
| المصدر: |
Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research). 2023, Vol. 14 Issue 10, p44-52. 9p. |
| مصطلحات موضوعية: |
*BOWEL obstructions, *LACTATES, *STRANGLING, *LACTATE dehydrogenase, *INTESTINAL ischemia, *LONGITUDINAL method, *MESENTERIC ischemia |
| مستخلص: |
Background - Laboratory tests are essential in patients with bowel obstruction because they may aid in the diagnosis and more importantly any underlying metabolic defects should be corrected prior to operative therapy. While no rest in sensitive and specific enough to diagnose mesenteric ischemia reliably, a spectrum of laboratory tests may be helpful in determining the condition of the patient and should guide resuscitation. Arterial blood pH, serum lactate concentrations and amylase and lactic dehydrogenase activity may be useful tests in the evaluation of bowel obstruction, especially when trying to exclude the presence of strangulation or underlying bowel necrosis. An increase in serum lactate concentrations should raise the suspicion of intestinal ischemia. Intestinal fatty acid binding protein (I-FABP) is a highly sensitive marker for extensive mesenteric infarction. Material and Methods - The aim of this prospective observational study is to evaluate the role of Serum Lactate as a marker of strangulation in bowel obstruction. 50 cases admitted in Emergency General Surgery ward, S.C.B. Medical College, Cuttack with clinical suspicion of intestinal obstruction for a period of 6 months (February 2021 to Feb 2022). Assessment and comparison of serum lactate levels in various outcomes of intestinal obstruction is done. Results - The mean serum lactate value in the patients were 5.16 mmol/L ranging between 1.70 to 8.60 mmol/L. The cut off values of strangulation, simple obstruction and those subacute cases managed conservatively were 4.3,3.4 and less than 2.3 respectively. Based on these values, 72% were classified as strangulation, 22% with strong suspicion and 6% of them were normal. Kruskal-Wallis test for comparison of serum lactate values across the three groups with normal, strong suspicion and strangulation shows that the results are significant with a chi-square value of 30.23 with p=0.00123(highly significant). Conclusion - A positive correlation between elevated serum lactate and strangulation bowel obstruction had been established, i.e. serum lactate levels were significantly raised in strangulated bowel obstruction as compared with simple bowel obstruction. [ABSTRACT FROM AUTHOR] |
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