What Is the Most Sensitive and Specific Laboratory Test(s) for the Detection of Acute Mesenteric Ischemia? What Is the Utility of Lactate? Are There Other Laboratory Tests Which Are Helpful in Making the Diagnosis?
Current laboratory tests have overall poor sensitivity and specificity for the diagnosis of acute mesenteric ischemia (AMI), despite multiple attempts to validate both old and novel biomarkers. Elevated WBC count is nearly ubiquitous among patients with AMI. Serum lactate levels correlate with both irreversible bowel necrosis and mortality but are not an early marker of disease. D-dimer may have use as a negative predictive marker, but it is not a sufficiently specific or sensitive when positive. Intestinal fatty acid-binding protein (I-FABP) shows promise as a novel biomarker but requires further validation before it is appropriate for clinical use.
KeywordsAcute mesenteric ischemia Biomarker Bowel necrosis Lactate D-dimer Intestinal fatty acid-binding protein Troponin I
- 3.Bala M, Kashuk J, Moore E, Kluger Y, Biffl W, Gomes C, et al. Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery. World J Emerg Surg.2017;12(38). https://doi:10.1186/s13017-017-0150-5Google Scholar