Intestinal Ischema Research Paper

PROCALCITONIN AS A PREDICTIVE VALUE FOR INTESTINAL ISCHEMIA AND NECROSIS IN ACUTE INTESTINAL OBSTRUCTION PATIENTS UNDERWENT URGENT OPERATION

Abd-El-Aal A. Saleem1, Emad F. Kholef2

1 Department of General Surgery, Faculty of Medicine, Aswan University, Aswan, Egypt.

2 Department of clinical pathology, Faculty of Medicine, Aswan University, Aswan, Egypt.

Correspondence to Abd-El-Aal A. Saleem, MD, Department of General Surgery, Faculty of Medicine, Aswan University, Aswan, Egypt.

Tel.: [phone] e-mail:[e-mail] ABSTRACT

OBJECTIVE

To assess the value of procalcitonin for early detection of intestinal ischemia

It is a dangerous condition that requires immediate diagnosis and urgent appropriate treatment [2]. Surgeons are mainly concerned with intestinal obstruction because accurate and early recognition of bowel strangulation still remains a difficult problem and is associated with high morbidity and mortality [3]. The majority of surgeons, therefore, continue to support the idea that the sun should not rise or set on patients with acute intestinal obstruction, in other words, they contend that early operation is always necessary [4]. Intestinal ischemia is a major health problem that accounts for 1-2% of intestinal diseases[5]. In United States, intestinal ischemia accounts for 0.1% of all hospital admissions, the incidence of this condition has increased over the last few decades ( from 1 in 1000 to 1 in 200 hospitalization for abdominal pain). In most cases, intestinal ischemia requires emergency treatment to avoid tissue necrosis, infectious outcomes, septic shock or lethal multiple organ failure [6]. Intestinal ischemia has been defined as impairment of the intestinal blood supply from celiac axis, superior mesenteric artery and inferior mesenteric artery, this results in tissue injury and a low-flow state with poor intestinal arterial perfusion [ 7]. Procalcitonin (PCT) is a 116-amino-acid (AA) precursor of calcitonin [8], that was first

In a period from 1st January 2016 to 30th December 2016.The number of cases were eighty ( 80) patients underwent urgent surgical operations and analysis of their records. Data were collected by us and our residents in emergency departments of Aswan University Hospital. The consent was taken from patients or their guardians and relatives. Diagnosis of acute intestinal obstruction was made based on clinical and radiological criteria. Those patients were divided into two groups ( A & B ). Group A (28 patients) was considered as non-ischemia group. Group B (52 patients) was considered as ischemia group. This group B was divided into two subgroups (B1 and B2). B1 ( 32 patients) was considered as reversible ischemia group and B2 ( 20 patients) was considered as irreversible ischemia group ( Necrosis group ). Also group A and subgroup B1 were considered as non-necrosis group ( 60 patients ). Group C (control group) include 20 patients not suffering from acute bowel obstruction, other emergency diseases or anybody infections, but complaining from other elective surgical problems e.g:- lipoma, non-infected sebaceous cyst…etc. The collected data include