Prathapan Anandapadmanabhan, Walwekar Arun, Hosamani Ishwar R, Walwekar Rekha
General Surgery, Believers Church Medical College Hospital, Thiruvalla, IND.
General Surgery, Karnataka Institute of Medical Sciences, Hubli, IND.
Cureus. 2024 Aug 27;16(8):e67980. doi: 10.7759/cureus.67980. eCollection 2024 Aug.
Background Intestinal obstruction continues to be one of the most common causes of emergencies presenting to the surgical department. A thorough clinical examination along with relevant investigations continue to be best modality for timely management and prompt decision-making in such cases. Objectives The aim of this study was to identify patients of intestinal obstruction with elevated levels of serum lactate dehydrogenase (LDH) and correlate elevated LDH levels with bowel viability. Materials and methods The study comprised 46 cases of intestinal obstruction and their serum LDH values measured prior to surgical intervention/first day of admission. The intra-operative bowel viability was noted and compared with LDH values obtained, and their correlation was studied along with other variables of the patient. Results In our study, it was found that a serum LDH level of >800 IU/L signified an abnormal bowel with increased risk of bowel gangrene, as indicated by a sensitivity of 75% and a specificity of 94%. Gangrenous bowel was found to be more associated with causes such as superior mesenteric artery/vein thrombosis, volvulus, and habits such as alcoholism and tobacco consumption. Elevated LDH levels, however, do not correlate with the length of the affected gangrenous bowel, with the duration of presentation of symptoms, or as a predictor of mortality. Conclusion Serum LDH can be used as a good predictor of gangrenous bowel in cases of intestinal obstruction.
背景 肠梗阻仍然是外科急诊最常见的病因之一。全面的临床检查以及相关检查仍然是对此类病例进行及时治疗和迅速决策的最佳方式。目的 本研究的目的是识别血清乳酸脱氢酶（LDH）水平升高的肠梗阻患者，并将升高的LDH水平与肠管活力相关联。材料与方法 本研究纳入46例肠梗阻患者，在手术干预前/入院第一天测量其血清LDH值。记录术中肠管活力并与所获得的LDH值进行比较，同时研究其与患者的其他变量之间的相关性。结果 在我们的研究中，发现血清LDH水平>800 IU/L表明肠管异常，肠坏死风险增加，敏感性为75%，特异性为94%。发现坏死肠管更多与肠系膜上动脉/静脉血栓形成、肠扭转等病因以及酗酒和吸烟等习惯有关。然而，升高的LDH水平与受影响坏死肠管的长度、症状出现的持续时间或死亡率的预测无关。结论 在肠梗阻病例中，血清LDH可作为坏死肠管的良好预测指标。
