Mesenteric ischemia laboratory findings: Difference between revisions
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'''Laboratory findings when bowel necrosis has occured:''' | '''Laboratory findings when bowel necrosis has occured:''' | ||
'''Late findings:''' | |||
* Hyperphosphatemia | * Hyperphosphatemia | ||
* Hyperkalemia | * Hyperkalemia | ||
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Overview
Laboratory Findings
The commonly seen laboratory findings in mesenteric ischemia include:[1]
Early findings:
(More sensitive)[2][3][4][5][6]
- Leukocytosis with predominance of immature white blood cells
- Hemoconcentration
- High anion gap metabolic acidosis
- Lactic acidosis (I-lactate) 86% sensitivity and 44% sensitivity
(Less sensitive)[7][8][4][9][10][11]
High levels of
- Serum amylase (50% sensitivity)
- Phosphate (80% sensitivity)
- Aspartate aminotransferase
- Lactate dehydrogenase
- Creatine phosphokinase
Abnormality in the lab findings is mostly seen after the infarction of the bowel has ensued. However, any patient with unrecognized abdominal pain and high anion gap metabolic acidosis should be ruled out for mesenteric ischemia.
Laboratory findings when bowel necrosis has occured:
Late findings:
- Hyperphosphatemia
- Hyperkalemia
References
- ↑ Graeber GM, Cafferty PJ, Wolf RE, Harmon JW (1984). "An analysis of creatine phosphokinase in the mucosa and the muscularis of the gastrointestinal tract". J Surg Res. 37 (5): 376–82. PMID 6333551.
- ↑ Cudnik MT, Darbha S, Jones J, Macedo J, Stockton SW, Hiestand BC (2013). "The diagnosis of acute mesenteric ischemia: A systematic review and meta-analysis". Acad Emerg Med. 20 (11): 1087–100. doi:10.1111/acem.12254. PMID 24238311.
- ↑ Lange H, Jäckel R (1994). "Usefulness of plasma lactate concentration in the diagnosis of acute abdominal disease". Eur J Surg. 160 (6–7): 381–4. PMID 7948358.
- ↑ 4.0 4.1 Glenister KM, Corke CF (2004). "Infarcted intestine: a diagnostic void". ANZ J Surg. 74 (4): 260–5. doi:10.1111/j.1445-2197.2004.02956.x. PMID 15043738.
- ↑ Zhang FX, Ma BB, Liang GZ, Zhang H (2011). "Analysis of serum enzyme levels in a rabbit model of acute mesenteric ischemia". Mol Med Rep. 4 (6): 1095–9. doi:10.3892/mmr.2011.553. PMID 21842126.
- ↑ van der Voort PH, Westra B, Wester JP, Bosman RJ, van Stijn I, Haagen IA; et al. (2014). "Can serum L-lactate, D-lactate, creatine kinase and I-FABP be used as diagnostic markers in critically ill patients suspected for bowel ischemia". BMC Anesthesiol. 14: 111. doi:10.1186/1471-2253-14-111. PMC 4384375. PMID 25844063 : 25844063 Check
|pmid=value (help). - ↑ Graeber GM, Wukich DK, Cafferty PJ, O'Neill JF, Wolf RE, Ackerman NB; et al. (1981). "Changes in peripheral serum creatine phosphokinase (CPK) and lactic dehydrogenase (LDH) in acute experimental colonic infarction". Ann Surg. 194 (6): 708–15. PMC 1345383. PMID 7305484 : 7305484 Check
|pmid=value (help). - ↑ Graeber GM, Cafferty PJ, Reardon MJ, Curley CP, Ackerman NB, Harmon JW (1981). "Changes in serum total creatine phosphokinase (CPK) and its isoenzymes caused by experimental ligation of the superior mesenteric artery". Ann Surg. 193 (4): 499–505. PMC 1345104. PMID 7212812.
- ↑ Graeber GM, Wolf RE, Harmon JW (1984). "Serum creatine kinase and alkaline phosphatase in experimental small bowel infarction". J Surg Res. 37 (1): 25–32. PMID 6738045.
- ↑ Wilson C, Imrie CW (1986). "Amylase and gut infarction". Br J Surg. 73 (3): 219–21. PMID 2418904.
- ↑ Jamieson WG, Marchuk S, Rowsom J, Durand D (1982). "The early diagnosis of massive acute intestinal ischaemia". Br J Surg. 69 Suppl: S52–3. PMID 7082974.