[Myocardial enzymes in the serum after high and low laparotomy]

The serum activities of ASAT, ALAT, LDH, creatine kinase (CK) and creatine kinase B (CK-B) were measured perioperatively in 20 patients in connection with vagotomy or subtotal/total gastrectomy and in 20 patients in connection with resection of the rectum. None of the patients presented clinical or serial electrocardiographic signs of acute myocardial infarction (AMI). ASAT, ALAT and LDH showed moderate increases postoperatively, the median values of which were within the reference range, and no statistical differences were found between the maximal values for these enzymes between patients with high and low laparotomies. In both patient categories, CK and CK-B showed marked postoperative increase and the maximal values for these enzymes were significantly higher in the group of patients subjected to high laparotomies, presumably on account of more pronounced muscle trauma in this group. The discriminative limits for CK-B as regards AMI diagnosis usually employed were found to be unsuitable after stomach and rectum surgery. The traditional myocardial enzymes must be interpreted with restraint after laparotomy as regards the diagnosis of AMI. A discriminative limit for CK-B% (maximal CK-B/total CK) of 6 is probably more suitable.