Preliminary study of D-dimer as a possible marker of acute bowel ischaemia

• Published in: British journal of surgery 2001-03, Vol.88 (3), p.385-388
• Main Authors: Acosta, S., Nilsson, T. K., Björck, M.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Biomarkers - analysis; Embolism - diagnosis; Female; Fibrin Fibrinogen Degradation Products - metabolism; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Intestines - blood supply; Ischemia - diagnosis; Male; Medical sciences; Mesenteric Artery, Superior; Mesenteric Vascular Occlusion - diagnosis; Middle Aged; Other diseases. Semiology; Sensitivity and Specificity; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Thrombosis - diagnosis
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1046/j.1365-2168.2001.01711.x

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. Conclusion: 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. © 2001 British Journal of Surgery Society Ltd