title: [Acute intestinal ischemia serum markers for the diagnosis of acute appendicitis].
abstract: BACKGROUND
  Acute appendicitis is the most common surgical emergency of the abdomen, but is still misdiagnosed in a large number of cases because of the the poor accuracy of the different radiologic and laboratory exams. Like in intestinal ischemia, an ischemic factor causes necrosis of the appendiceal wall and this favors the release of particular biochemical serum markers.
  
  
  OBJECTIVE
  To evaluate the efficacy of intestinal ischemia serum markers as a diagnostic test for acute appendicitis.
  
  
  METHODS
  Two hundred patients were studied prospectively. Depending on results of the examination by a surgeon, patients underwent surgery for acute appendicitis. Serum levels of amylase, lactic dehydrogenase, alkaline phosphatase, alanine transaminase, aspartate transaminase and leucocyte count were taken preoperatively. We then compared the results with histopathologic findings.
  
  
  RESULTS
  Appendicitis was confirmed in 176 patients. Leukocytes had the highest sensitivity but very low specificity. Amylase and DHL were very specific but their sensitivity was poor. Differential leukocyte count had the highest positive predictive value.
  
  
  CONCLUSIONS
  Serum enzymes of intestinal ischemia are not useful markers for the diagnosis of acute appendicitis. Leukocyte count is still the most useful serum marker of appendicitis.
authors.affiliation: Departamento de Cirugía General, Hospital General Dr. Manuel Gea González, Calzada de Tlalpan 4800, Col. Toriello Guerra, 14000 México DF, México. rodrigomenendez@hotmail.com
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Menéndez-Arzac
authors.forename: Eduardo
authors.initials: E
authors.lastname: Cárdenas-Lailson
authors.forename: Carlos Alberto
authors.initials: CA
authors.lastname: Sanjuán-Martínez
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rebolledo-López
authors.forename: Sara
authors.initials: S
authors.lastname: Parraguirre-Martínez
authors.forename: Lluvia
authors.initials: L
authors.lastname: Léon
authors.forename: María del Pilar
authors.initials: Mdel P
authors.lastname: Mata-Miranda
mesh_terms: D000208:Acute Disease; D000328:Adult; D001064:Appendicitis / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000097:blood*; D008297:Male; D011446:Prospective Studies
chemical_list: D015415:Biomarkers