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Related Experiment Videos

Serum enzyme levels during intestinal ischemia.

J S Thompson1, L E Bragg, W W West

  • 1Department of Surgery, Omaha VAMC, Nebraska.

Annals of Surgery
|March 1, 1990
PubMed
Summary

Seromuscular enzymes, especially creatinine phosphokinase, are better indicators of intestinal ischemia than mucosal enzymes. These enzyme levels were elevated following ischemic injury, regardless of injury extent or reversibility.

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Area of Science:

  • Gastroenterology
  • Surgical Research
  • Biochemistry

Background:

  • Intestinal ischemia poses a significant clinical challenge.
  • Serum levels of mucosal enzymes are hypothesized to indicate intestinal ischemia due to mucosal sensitivity.
  • Diamine oxidase (DAO) and alkaline phosphatase (ALP) are mucosal enzymes, while creatinine phosphokinase (CPK), lactic dehydrogenase (LDH), and serum glutamic oxaloacetic transaminase (SGOT) are seromuscular enzymes.

Purpose of the Study:

  • To compare the diagnostic utility of serum mucosal and seromuscular enzymes in detecting intestinal ischemia.
  • To evaluate the impact of ischemia extent and duration on serum enzyme levels.
  • To determine if enzyme elevation correlates with histological findings.

Main Methods:

  • A canine model was used to induce varying degrees of intestinal ischemia.

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  • Groups included sham laparotomy, 50% small intestine devascularization, 2-hour superior mesenteric artery occlusion with release, and superior mesenteric artery ligation.
  • Serum enzyme levels (DAO, ALP, CPK, LDH, SGOT) were measured pre- and post-operatively (2, 4, 8, 24 hours).
  • Histological examination was performed at 4 hours.

    • Main Results:

    • Creatinine phosphokinase (CPK) levels elevated significantly within 4 hours in groups with devascularization and ligation.
    • Most serum enzymes, excluding DAO, showed significant elevation at 24 hours post-ischemia in groups 2, 3, and 4.
    • Elevated enzyme levels were observed even in cases with normal histology after temporary ischemia.
    • Enzyme level changes were independent of the extent and reversibility of ischemic injury.

    Conclusions:

    • Seromuscular enzymes, particularly CPK, are more sensitive indicators of intestinal ischemia than mucosal enzymes.
    • Serum enzyme elevation can occur even with temporary or reversible ischemic events.
    • The degree and reversibility of ischemia did not significantly influence the observed enzyme level changes.