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Updated: Jul 5, 2025
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Evaluation of intestinal necrosis with laser Doppler in experimental mesenteric ischemia model
Nurullah Aksoy1, Davut Sinan Kaplan2, Mustafa Orkmez3
1Department of General Surgery, International Adn Hospital, Gaziantep-Türki̇ye.
Background:
Acute mesenteric ischemia (AMI) is responsible for one in a thousand emergency hospital admissions in America and Europe and is associated with high morbidity and mortality rates. Current diagnostic and treatment methods fall short of desired outcomes, often resulting in delayed diagnoses and difficulties in detecting ischemic bowel tissue during treatment. This study evaluates the diagnostic value of commonly used biochemical markers in clinical practice-creatine kinase, C-reactive protein (CRP), and lactate dehydrogenase (LDH)-alongside blood flow measurements using laser Doppler in a rat model of experimental mesenteric ischemia. We also compare these markers with pathological ischemia scoring.
Methods:
Rats were divided into five groups: control, 1 hour, 2 hours, 3 hours, and 4 hours. Mesenteric ischemia was induced for the respective durations in each group. After these periods, we measured blood flow using laser Doppler. We also collected blood samples and intestinal biopsies for biochemical parameter analysis. These values were assessed in relation to intestinal viability using the Chiu ischemia scoring system.
Results:
Blood flow measurement with laser Doppler correlated with both the duration and severity of bowel ischemia. No significant relationship was found between CRP levels and the duration of ischemia. However, creatine kinase and lactate dehydrogenase (LDH) levels were significantly higher in ischemia lasting into the third and fourth hours.
Conclusion:
Creatine kinase and lactate dehydrogenase (LDH) levels may be useful biomarkers in patients with suspected acute mesenteric ischemia (AMI). Blood flow measurements using laser Doppler can accurately identify intestinal loops for resection during surgery.
Insights
Creatine kinase and lactate dehydrogenase (LDH) show promise as biomarkers for acute mesenteric ischemia (AMI). Laser Doppler flowmetry aids in surgical decisions by identifying compromised bowel tissue.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Biochemical Diagnostics
Background:
- Acute mesenteric ischemia (AMI) presents a significant clinical challenge with high mortality.
- Current diagnostic tools for AMI often lead to delayed detection and treatment.
- There is a need for improved methods to diagnose and manage ischemic bowel conditions.
Purpose of the Study:
- To evaluate the diagnostic utility of creatine kinase, C-reactive protein (CRP), and lactate dehydrogenase (LDH) in a rat model of AMI.
- To assess the effectiveness of laser Doppler flowmetry in detecting bowel ischemia.
- To compare biochemical markers and blood flow measurements with pathological scoring of intestinal viability.
Main Methods:
- Experimental induction of mesenteric ischemia in rats for varying durations (1-4 hours).
- Measurement of blood flow using laser Doppler.
- Analysis of serum creatine kinase, CRP, and LDH levels.
- Assessment of intestinal viability using the Chiu ischemia scoring system.
Main Results:
- Laser Doppler measurements effectively correlated with the duration and severity of mesenteric ischemia.
- No significant correlation was observed between CRP levels and ischemia duration.
- Creatine kinase and LDH levels were significantly elevated in cases of prolonged ischemia (3-4 hours).
Conclusions:
- Creatine kinase and LDH may serve as valuable biomarkers for diagnosing AMI.
- Laser Doppler flowmetry is a reliable tool for identifying ischemic bowel segments during surgery.
- Combined use of biochemical markers and blood flow assessment can improve AMI management.
