A prospective study of serum C-reactive protein and D-lactate levels for early prediction of strangulation in intestinal obstruction

Background: Intestinal obstruction is one of the commonest clinical problems encountered in surgical practice. One of the grave complications of intestinal obstruction is strangulation, which requires an emergency laparotomy for management. This study was conducted to emphasise the significance of early estimation of rise in serum C-reactive protein and D- lactate levels.Methods: Hospital based prospective study was performed on 50 patients admitted in J.L.N. Hospital, Ajmer in various surgical units with diagnosis of acute intestinal obstruction and underwent explorative Laparotomy.Results: CRP test sensitivity was 85.00%, specificity was 80.67%, PPV was 73.91% and NPV was 88.89% to detected the obstruction with strangulation when using a cutoff value of 60 mg/L. D-lactate test sensitivity was 80.00%, specificity was 90.00%, PPV was 84.30% and NPV was 87.10% to detected the obstruction with strangulation when using a cutoff value of 4.5 mmol/L.Conclusions:Serum CRP and D-lactate can be useful and reasonable markers for predicting strangulation in cases of acute intestinal obstruction in an emergency setting.

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Combination of Serum C-reactive Protein and D-lactate: Predictors of Strangulation in Intestinal Obstruction

Panamerican Journal of Trauma, Critical Care & Emergency Surgery ◽

10.5005/jp-journals-10030-1156 ◽

2016 ◽

Vol 5 (3) ◽

pp. 134-139 ◽

Cited By ~ 1

Author(s):

Ajay K Pal ◽

Maulana M Ansari ◽

Najmul Islam

Keyword(s):

Intestinal Obstruction ◽

Bowel Obstruction ◽

Acute Intestinal Obstruction ◽

Emergency Setting ◽

C Reactive Protein ◽

Predictive Values ◽

Cutoff Value ◽

Reactive Protein ◽

Sensitivity Specificity ◽

Serum Crp

ABSTRACT Introduction Serum C-reactive protein (CRP) and D-lactate have been proposed as markers of intestinal ischemia. The purpose of this prospective observational study is to find whether serum CRP and serum D-lactate can help in predicting strangulation in cases of acute intestinal obstruction. Materials and methods A total of 50 consecutive patients were included in the study after excluding patients of comorbid medical illness and patients with findings other than obstruction or strangulation. The serum values of CRP and D-lactate were measured and compared between obstruction with strangulation and obstruction without strangulation. Receiver operating characteristic (ROC) curve was drawn and cutoff values for the diagnosis of strangulation were calculated along with calculation of sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs). Results A total of 14 patients who were diagnosed with strangulated bowel obstruction had significantly higher values of serum CRP and D-lactate when compared with 36 patients with simple bowel obstruction (116 vs 40 mg/L and 5.4 vs 2.7 mmol/L respectively, p < 0.05). Using ROC analysis, the area under the curve of serum CRP and D-lactate was found to be 0.785 and 0.775 respectively, for bowel strangulation. Using a cutoff value of 60 mg/L for CRP, the sensitivity, specificity, PPV, and NPV were 87.5, 58.3, 48.3, 91.3% respectively. Using a cutoff value of 4.5 mmol/L for D-lactate, the sensitivity, specificity, PPV, and NPV were 75.0, 69.4, 52.7, 86.2% respectively. Conclusion Serum CRP and D-lactate can be useful and reasonable markers for predicting strangulation in cases of acute intestinal obstruction in an emergency setting. How to cite this article Pal AK, Ansari MM, Islam N. Combination of Serum C-reactive Protein and D-lactate: Predictors of Strangulation in Intestinal Obstruction. Panam J Trauma Crit Care Emerg Surg 2016;5(3):134-139.

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Alteration of Body Temperature, Erythrocyte Sedimentation Rate, and C-reactive Protein After Reamed Intramedullary Nailing: A Prospective Study

Yearbook of Orthopedics ◽

10.1016/s0276-1092(08)70392-4 ◽

2006 ◽

Vol 2006 ◽

pp. 91

Author(s):

M.F. Swiontkowski

Keyword(s):

Body Temperature ◽

Prospective Study ◽

Erythrocyte Sedimentation Rate ◽

Intramedullary Nailing ◽

Sedimentation Rate ◽

C Reactive Protein ◽

Reactive Protein ◽

Erythrocyte Sedimentation ◽

A Prospective Study

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A RARE CASE OF HETEROTOPIC PANCREATIC TISSUE CAUSING SMALL BOWEL OBSTRUCTION

10.36106/gjra/0202569 ◽

2021 ◽

pp. 4-5

Author(s):

B. Santhi ◽

M. Annapoorani ◽

Sharada bhavana

Keyword(s):

Intestinal Obstruction ◽

Rare Case ◽

Histopathological Examination ◽

Pancreatic Tissue ◽

Acute Intestinal Obstruction ◽

Emergency Laparotomy ◽

Review Of Literature ◽

Heterotopic Pancreatic Tissue ◽

Small Growth ◽

Upper Gastrointestinal

A Rare case of heterotopic pancreatic tissue of ileum causing acute intestinal obstruction has been described with a brief review of literature. A 42 yr old male patient presented to the emergency department with features of acute intestinal obstruction. After evaluation patient was taken up for emergency laparotomy which revealed a band to be arising from ileum. Furthermore, there was a small growth in the ileal wall at the site of origin of the band. Hence resection of the growth was done and followed by ileoileal anastomosis. Later on, histopathological examination of the growth revealed it to be heterotopic pancreatic tissue. Heterotopic pancreatic tissue is often an incidental nding encountered in upper gastrointestinal tract during endoscopy and surgeries. But Symptomatic ectopic pancreas of ileum is relatively rare and they very rarely present with acute symptoms as in this case

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