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Updated: Jun 19, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
D-dimer in patients with suspected acute mesenteric ischemia
Yu-Hui Chiu1, Ming-Kun Huang, Chorng-Kuang How
1Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan.
Objectives:
The aims of this study were to assess the diagnostic value of D-dimer in patients with suspected acute mesenteric ischemia (AMI) and to evaluate the correlation between D-dimer levels and the severity of bowel necrosis.
Methods:
A prospective, noninterventional study of 67 patients with clinical suspicion of AMI was performed. Measurement of D-dimer levels was performed using a latex turbidimetric method.
Results:
Acute mesenteric ischemia was diagnosed in 23 patients (34.3%) and non-AMI in 44 patients (65.7%). Median D-dimer levels on admission were 6.24 microg fibrinogen equivalent units (FEU)/mL (range, 0.96-53.48 microg FEU/mL) in patients with AMI and 3.45 microg FEU/mL (range, 0.50-44.69 microg FEU/mL) in non-AMI patients (P = .064). D-dimer had poor discriminative value to differentiate the presence from the absence of AMI with an area under the receiver operating characteristic curve of 0.64 (95% confidence interval, 0.50-0.78). A serum D-dimer cutoff value of 1.0 microg FEU/mL had a sensitivity of 96%, a specificity of 18%, a positive likelihood ratio of 1.17, and a negative likelihood ratio of 0.24. Among patients with AMI verified at operation, 8 had resectable bowl necrosis and 9 had unresectable bowel necrosis. There was no difference in serum D-dimer levels between resectable and unresectable bowel necrosis (P = .665).
Conclusions:
Detection of serum D-dimer could not help to differentiate patient with AMI from those with non-AMI. We did not find a correlation between serum D-dimer levels and the severity of AMI. However, measurement of D-dimer levels can be of value for a small decrease in the likelihood of AMI, when the result is low.
Insights
Serum D-dimer testing has poor diagnostic value for acute mesenteric ischemia (AMI). While a low D-dimer level may slightly decrease the likelihood of AMI, it cannot reliably differentiate AMI from other conditions or predict disease severity.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Emergency Medicine
- Diagnostic Imaging
Background:
- Acute mesenteric ischemia (AMI) is a critical condition requiring prompt diagnosis.
- D-dimer is a biomarker often assessed in patients with suspected vascular events.
- The diagnostic utility of D-dimer in AMI remains debated.
Purpose of the Study:
- To evaluate the diagnostic performance of D-dimer in patients with suspected AMI.
- To determine the correlation between D-dimer levels and the extent of bowel necrosis in AMI.
Main Methods:
- Prospective study of 67 patients with clinical suspicion of AMI.
- D-dimer levels measured using a latex turbidimetric method.
- Analysis of diagnostic accuracy and correlation with surgical findings.
Main Results:
- AMI diagnosed in 34.3% of patients; non-AMI in 65.7%.
- Median D-dimer levels were higher in AMI patients (6.24 µg FEU/mL) vs. non-AMI (3.45 µg FEU/mL), but not statistically significant (P=.064).
- D-dimer showed poor discrimination for AMI (AUC=0.64) and no correlation with bowel necrosis severity.
Conclusions:
- Serum D-dimer lacks sufficient diagnostic value to distinguish AMI from non-AMI.
- D-dimer levels do not correlate with the severity of bowel necrosis in AMI.
- A low D-dimer result may offer a marginal reduction in the probability of AMI.
