The role of d-lactate in differential diagnosis of acute appendicitis.
BACKGROUND
Early diagnosis of acute appendicitis, known as the most frequent cause of acute surgical abdominal pathologies, dramatically decreases the related complications. D-lactate, produced by intestinal bacteria as a fermentation product, may be useful in diagnosing acute abdominal pathologies. The aim of this study was to investigate whether the presence of d-lactate would be a significant indicator in the early diagnosis of acute appendicitis.


METHODS
Eighty consecutive patients were prospectively included in this study. The patients were divided into four groups: acute appendicitis (group 1), perforated acute appendicitis (group 2), nonspecific abdominal pain (group 3), and acute abdomen other than acute appendicitis (group 4). For the control group, blood samples were taken in the same manner from 20 healthy subjects.


RESULTS
There was no significant difference in blood d-lactate levels between the simple acute appendicitis and acute perforated appendicitis groups (p > .05). The blood d-lactate levels in groups 1 and 2 were significantly higher than those in groups 3 and 4, and the control group (p < .001). The reliability of d-lactate was determined as 97% sensitivity, 93% specificity, 90% positive predictive and 95% negative predictive values, and 95% accuracy.


CONCLUSIONS
Based on findings in this study, blood d-lactate level may be a valuable diagnostic marker for the diagnosis of acute appendicitis.
Filiz
Ali Ilker
AI
Department of General Surgery, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul 34668, Turkey.
Aladag
Hakan
H
Akin
Mehmet Levhi
ML
Sucullu
Ilker
I
Kurt
Yavuz
Y
Yucel
Ergun
E
Uluutku
Ahmet Haldun
AH
D015746:Abdominal Pain / Q000097:blood / Q000175:diagnosis*; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
D015415:Biomarkers; D019344:Lactic Acid