Department of Emergency Medicine-Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
Department of Emergency Medicine-Ospedale San Carlo di Nancy GVM care and research, Rome, Italy.
Rev Recent Clin Trials. 2024;19(1):70-75. doi: 10.2174/0115748871259008231006071656.
Abdominal pain is a frequent reason for admission to the Emergency Department. It may be a symptom of an underlying "organic" disease or a "functional" manifestation without an underlying anatomic or physiologic alteration. The evaluation of patients with abdominal pain is a challenge for the emergency physician and the selection of patients for second-level radiological examinations or endoscopic procedures is not always easy to perform. Faecal calprotectin could be a useful diagnostic marker to distinguish between "organic" or "functional" form and its determination could be helpful to select patients for further examinations in the context of an emergency setting.
This is an observational and retrospective study on 146 patients with abdominal pain and/or diarrhea (with or without rectal bleeding) admitted to the Emergency Department of Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, who collected a fecal sample to evaluate fecal calprotectin. We evaluated and correlated the level of fecal calprotectin with the final diagnosis they received.
50/146 patients (34,24%) received a diagnosis of acute diverticulitis, in particular, 14/50 (28%) were complicated and 36/50 (72%) were uncomplicated; 4/146 (2,7%) were cholangitis, 32/146 (21,9%) were colitis, 6/146 (4,1%) gastritis, 42/146 (28,7%), Irritable bowel syndrome and 12/146 (8,2%) Inflammatory bowel disease. For the differential diagnosis between Irriable or inflammatory bowel diseses, our study showed a VPP and a VPN of 100% meanwhile for the differential diagnosis between Acute complicated and uncomplicated diverticulitis, our study showed a VPP of 40% and a VPN of 84%.
In the emergency setting, faecal calprotectin could be a helpful marker to select patients with abdominal pain who need second-level radiological examinations or endoscopic procedures, guiding the emergency physician in the evaluation of such a complex and wideranging symptom.
腹痛是急诊科就诊的常见原因。它可能是潜在“器质性”疾病的症状，也可能是一种无潜在解剖或生理改变的“功能性”表现。对腹痛患者的评估对急诊医生来说是一个挑战，选择患者进行二级放射学检查或内镜检查并不总是容易做到的。粪便钙卫蛋白可能是区分“器质性”或“功能性”形式的有用诊断标志物，其测定有助于在急诊环境下选择需要进一步检查的患者。
这是一项对 146 例腹痛和/或腹泻（伴有或不伴有直肠出血）患者的观察性回顾性研究，这些患者在罗马的 Fondazione Policlinico Universitario A. Gemelli IRCCS 急诊科就诊时采集粪便样本以评估粪便钙卫蛋白。我们评估并将粪便钙卫蛋白的水平与他们最终诊断相关联。
146 例患者中有 50 例（34.24%）被诊断为急性憩室炎，其中 14/50 例（28%）为复杂性，36/50 例（72%）为非复杂性；4/146 例（2.7%）为胆管炎，32/146 例（21.9%）为结肠炎，6/146 例（4.1%）为胃炎，42/146 例（28.7%）为肠易激综合征，12/146 例（8.2%）为炎症性肠病。为了区分肠易激或炎症性肠病，我们的研究显示其阳性预测值和阴性预测值均为 100%；而在区分急性复杂和非复杂性憩室炎时，我们的研究显示阳性预测值为 40%，阴性预测值为 84%。
在急诊环境中，粪便钙卫蛋白可能是一种有用的标志物，可以选择需要进行二级放射学检查或内镜检查的腹痛患者，指导急诊医生评估这种复杂而广泛的症状。
