Department of General Surgery, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey.
Department of General Surgery, Balikesir Ataturk City Hospital, Balikesir, Turkey.
Medicine (Baltimore). 2024 May 31;103(22):e38365. doi: 10.1097/MD.0000000000038365.
Acute mesenteric ischemia (AMI) is a potentially fatal abdominal emergency. The estimation of the severity of AMI is of great importance since changes in disease severity may have different impacts on the treatment options. This study aims to define laboratory and radiological parameters that can successfully predict the severity of AMI. Data from 100 patients who were treated conservatively and underwent an operation with a diagnosis of AMI between the years 2010 and 2019 were reviewed. The patients were divided into 3 groups as those treated with a conservative approach (group 1), those with partial intestinal ischemia (group 2), and those with complete intestinal ischemia (group 3) according to the pathology results. Laboratory findings of the patients were recorded and matched with radiological findings. The white blood cell (WBC) count, neutrophil (NEUT) count, neutrophil/lymphocyte ratio, and C-reactive protein/albumin ratios were the considered distinctive parameters for distinguishing the third group from the first group. However, the same result cannot be applied to the first and the second groups since only the WBC and NEUT counts showed distinctive performance. The measurement of neutrophil/lymphocyte ratio, WBC, NEUT, and albumin levels can be used to predict the severity of AMI. We believe that evaluating these laboratory parameters will greatly prevent possible morbidity and mortality in the patient. Also, we were able to observe that the parameters used in predicting AMI severity can be verified with rapid and low-cost radiological imaging techniques.
急性肠系膜缺血(AMI)是一种潜在致命的腹部急症。评估 AMI 的严重程度非常重要,因为疾病严重程度的变化可能对治疗选择产生不同的影响。本研究旨在确定可成功预测 AMI 严重程度的实验室和影像学参数。回顾了 2010 年至 2019 年间接受保守治疗和手术诊断为 AMI 的 100 例患者的数据。根据病理结果,患者分为三组:接受保守治疗的患者(第 1 组)、部分肠缺血的患者(第 2 组)和完全肠缺血的患者(第 3 组)。记录患者的实验室检查结果并与影像学结果相匹配。白细胞(WBC)计数、中性粒细胞(NEUT)计数、中性粒细胞/淋巴细胞比值和 C 反应蛋白/白蛋白比值被认为是区分第 3 组和第 1 组的特征参数。然而,由于只有 WBC 和 NEUT 计数表现出特征性,因此不能将相同的结果应用于第 1 组和第 2 组。中性粒细胞/淋巴细胞比值、WBC、NEUT 和白蛋白水平的测量可用于预测 AMI 的严重程度。我们相信,评估这些实验室参数将极大地预防患者可能出现的发病率和死亡率。此外,我们还观察到,用于预测 AMI 严重程度的参数可以通过快速且低成本的影像学技术进行验证。