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Preliminary study of D-dimer as a possible marker of acute bowel ischaemia
S Acosta1, T K Nilsson, M Björck
1Department of Surgery, Blekinge Hospital Karlskrona, Karlskrona, Sweden. stefan.acosta@urokir.lu.se
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.