Intestinal Fatty Acid Binding Protein as a Predictor of Early Mesenteric Injury Preceding Clinical Presentation: A...

Area of Science:

• Vascular Surgery
• Gastroenterology
• Critical Care Medicine

Background:

• Non-occlusive mesenteric ischaemia (NOMI) presents diagnostic challenges due to non-specific symptoms and tests, leading to high mortality.
• Early detection of intestinal injury is crucial for improving patient outcomes in critical care settings.

Observation:

• A patient developed mesenteric ischaemia post-thoracic endovascular aneurysm repair (TEVAR) for type B aortic dissection (TBAD) complicated by cardiogenic shock.
• Elevated plasma intestinal fatty acid binding protein (I-FABP) levels were observed two days prior to the onset of clinical symptoms.
• The patient underwent emergency laparotomy and bowel resection due to peritonitis and perforation.

Findings:

• Plasma I-FABP levels increased significantly on post-operative days five and six.
• The elevated I-FABP levels preceded the clinical presentation of fever, peritonitis, and bowel perforation.
• Histopathological analysis confirmed mesenteric ischaemia.

Implications:

• Elevated I-FABP may serve as an early biomarker for mesenteric injury in high-risk patients.
• This case suggests I-FABP could aid in the early diagnosis of NOMI, potentially improving treatment strategies.
• Further research is warranted to validate I-FABP's utility in routine clinical practice for NOMI diagnosis.