The need and timing of surgical intervention in patients with adhesive bowel obstruction is a dilemma. We aimed to investigate the role of three acute-phase reactants, namely procalcitonin (PCT), fibrinogen and C-reactive protein (CRP) in this clinical condition We chose a rat model whose mechanical bowel obstruction was created with caecum ligation. There were two study groups and one control group. Each group contained ten subjects. The study groups had and six-hour obstruction samples. Blood PCT, fibrinogen and CRP levels were measured before and after the surgical procedure. These parameters were compared between the groups and they were also evaluated with the degree of histopathological changes occurred in terminal ileal tissue samples. Compared with the control group, PCT measurements showed a mild decrease in the early phase of obstruction but a significant elevation in the late phase (p: 0,977 and p: 0,001). Unlike PCT, fibrinogen levels increased at first but decreased later (p: 0,978 and p: 0,326). We observed an increase in CRP levels parallel to the prolonged duration of obstruction (p: 0,987 and p: 0,134). With regard to mucosal injury, PCT levels increased at first, and then decreased (p: 0,003). On the other hand, fibrinogen and CRP levels decreased at first, and then increased (p: 0,139 and p: 0,102). The acute-phase reactants PCT, fibrinogen and CRP associated with the duration of obstruction may help to determine the time of surgical intervention in patients with adhesive mechanical bowel obstruction.
Case report--mechanical bowel obstruction with appendicitis without strangulation and leukocytosis