Preliminary study of D-dimer as a possible marker of acute bowel ischaemia.
BACKGROUND
Occlusion of the superior mesenteric artery (SMA) demands prompt recognition and diagnosis. No accurate diagnostic method is available. The aim of this study was to determine whether the fibrinolytic marker D-dimer is a useful early marker of acute bowel ischaemia.


METHODS
Fourteen patients suspected of having acute bowel ischaemia were analysed for an increase in plasma D-dimer level.


RESULTS
Six patients had embolic or thrombotic occlusion of the SMA and all had significantly higher D-dimer levels than those without thromboembolic occlusion (P < 0.05). Four patients with strangulation of the small bowel due to adhesions and one with a ruptured aortic aneurysm also had raised D-dimer values.


CONCLUSIONS
In patients with suspected thromboembolic occlusive disease of the SMA, a raised level of D-dimer indicated the presence of acute bowel ischaemia, whatever the cause. A more extensive prospective study is needed to evaluate a potential survival benefit using the test as a marker of the need for urgent laparotomy.
Department of Surgery, Blekinge Hospital Karlskrona, Karlskrona, Sweden. stefan.acosta@urokir.lu.se
S
S
Acosta
T K
TK
Nilsson
M
M
Björck
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D004617:Embolism / Q000175:diagnosis; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000175:diagnosis*; D008297:Male; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis*; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013927:Thrombosis / Q000175:diagnosis
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D