title: The role of d-lactate in differential diagnosis of acute appendicitis.
abstract: 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.
authors.affiliation: Department of General Surgery, Gulhane Military Medical Academy, Haydarpasa Teaching Hospital, Istanbul 34668, Turkey.
authors.forename: Ali Ilker
authors.initials: AI
authors.lastname: Filiz
authors.forename: Hakan
authors.initials: H
authors.lastname: Aladag
authors.forename: Mehmet Levhi
authors.initials: ML
authors.lastname: Akin
authors.forename: Ilker
authors.initials: I
authors.lastname: Sucullu
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Kurt
authors.forename: Ergun
authors.initials: E
authors.lastname: Yucel
authors.forename: Ahmet Haldun
authors.initials: AH
authors.lastname: Uluutku
mesh_terms: 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
chemical_list: D015415:Biomarkers; D019344:Lactic Acid