Usefulness of plasma lactate concentration in the diagnosis of acute abdominal disease.
OBJECTIVE
To verify the diagnostic importance of the plasma lactate concentration in acute abdominal disease and to examine its role as a marker of mesenteric ischaemia.


METHODS
Prospective study.


METHODS
Two departments of surgery, one in Sweden and one in Germany.


METHODS
85 patients with acute abdominal symptoms.


METHODS
Correlation between the plasma lactate concentration before operation or (in the case of those not operated on) before the diagnosis was established, and the final diagnosis.


RESULTS
Plasma lactate concentrations exceeded the reference range in all cases of mesenteric ischaemia (n = 20) and general bacterial peritonitis (n = 15) and in half of the 20 cases of intestinal obstruction. They were also raised in 3 of 10 cases of acute pancreatitis.


CONCLUSIONS
A raised plasma lactate concentration is always a sign of an acute life-threatening condition, and usually indicates the need for an emergency operation. As a marker of mesenteric ischaemia its sensitivity was 100% and its specificity 42%. We conclude that a raised serum lactate concentration is the best marker of mesenteric ischaemia to date.
Lange
H
H
Surgical Department Hospital, Köping, Sweden.
Jäckel
R
R
D000006:Abdomen, Acute / Q000097:blood*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood*; D007773:Lactates / Q000097:blood*; D019344:Lactic Acid; D008297:Male; D008638:Mesenteric Arteries; D008641:Mesenteric Vascular Occlusion / Q000097:blood*; D008642:Mesenteric Veins; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood; D010538:Peritonitis / Q000097:blood; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D015415:Biomarkers; D007773:Lactates; D019344:Lactic Acid