The value of lab findings in early diagnosis of acute mesenteric ischemia

Objective: Acute mesenteric ischemia (IMA) is a vascular emergency with broad variability of clinical presentations and non-specific laboratory findings. Therefore, there is a significant need for reliable serological markers of ischemia. Various laboratory studies may be performed for suspected AMI, but in general, such studies will not establish the diagnosis.Methods: In a prospective, non-interventional study, from October ۲۰۱۲ to October ۲۰۱۳, we investigated ۷۰ patients with probable diagnosis of AMI. Blood samples were taken from patients and analyzed for complete blood count (CBC), prothrombin time (PT), partial thromboplastin time (PTT), international normalized ratio (INR), urea, creatinine (Cr), sodium (Na), potassium (K), D-dimer, lactate, amylase, PH, partial pressure of carbon dioxide (PCO۲), and bicarbonate (HCO۳). Finally the results were compared with AMI diagnosis confirmed by computed tomography (CT) angiography.Results: Seventy patients with acute severe abdominal pain were studied. Thirty-nine patients (۵۵.۷%) were male and ۳۱ patients (۴۴.۳%) were female. The average age was ۶۸.۰۱ ± ۱۴.۶۷ (±SD). Based on CT-angiography results, ۲۷ (۳۸.۶%) patients had AMI and ۴۳ (۶۱.۴%) patients did not have AMI. Chi-squire test showed P values of ۰.۶۰۶ and ۰.۹۸۶ for relations between sex and risk factors with AMI correspondingly. One-sample Kolmogorov-Smirnov revealed white blood cell (WBC), hemoglobin (Hb), platelets (Plt), urea, Cr, Na, K, PCO۲ and HCO۳ as normally distributed parameters (P > ۰.۰۵). Moreover PT, PTT, INR, D-dimer, lactate, amylase, and PH were non-normally distributed (P < ۰.۰۵).Conclusion: We found a significant relation between increased serum lactate level and definitive AMI diagnosis. We recommend rising serum lactate as a finding in AMI.

کلیدواژه ها:

Mesenteric ischemia ، Fibrin fragment D ، lactate ، Early Diagnosis