Journals / Dicle Tıp Dergisi / 2016 / Cilt: 43 - Sayı: 1

The Value of D-Dimer in Diagnosis of Acute Mesenteric Ischemia and Differential Diagnosis from Acute Pancreatitis and Acute Cholecystitis

Akut Mezenterik İskemi Tanısında ve Akut Pankreatit ile Akut Kolesistitten Ayırıcı Tanısında D-Dimerin Önemi

Pages
88–92
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

How- ever, to reveal the diagnostic value of D-dimer test more clearly, further studies with larger series are needed, where cut-off value is highly defined, and other patients with acute abdominal pain are added into the control group.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Because of its poor prognosis and high mor- tality rate, early diagnosis of acute mesenteric ischemia (AMI) is a challenge.
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Key Findings & Data:Methods: We included 89 patients who admitted to our emergency department with abdominal pain.
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Conclusion & Impact:How- ever, to reveal the diagnostic value of D-dimer test more clearly, further studies with larger series are needed, where cut-off value is highly defined, and other patients with acute abdominal pain are added into the control group.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: Because of its poor prognosis and high mor- tality rate, early diagnosis of acute mesenteric ischemia (AMI) is a challenge. The value of serum markers in the diagnosis of AMI is limited and the studies related with the D-dimer test carried out in recent years. In this prospec- tive study we investigated the value of the level of plasma D-dimer in the diagnosis of AMI and the differential diag- nosis from acute pancreatitis and acute cholecystitis. Methods: We included 89 patients who admitted to our emergency department with abdominal pain. The number and the diagnosis of the patients were 17 AMI, 42 acute pancreatitis and 30 acute cholecystitis, respectively. We measured the levels of plasma D-dimer of all patients by using a latex agglutination ‘immunoassay’ method. Even- tually we calculated the sensitivity and specificity of D- dimer test in the diagnosis of AMI. Results: We determined the specificity of the D-dimer test in the differential diagnosis of AMI as 50% from acute pancreatitis, 70% from acute cholecystitis, 58.3% from all the control group and the sensitivity was 100%. Conclusion: The measurement of plasma D-dimer con- centration may be useful in the differential diagnosis of AMI from acute pancreatitis and acute cholecystitis. How- ever, to reveal the diagnostic value of D-dimer test more clearly, further studies with larger series are needed, where cut-off value is highly defined, and other patients with acute abdominal pain are added into the control group.

Özet

Amaç: Kötü prognozu ve yüksek mortalite oranı nedeniy- le akut mezenterik iskemi (AMİ)’nin erken tanısı sorun- dur. AMİ’nin tanısında serum belirteçlerinin yeri oldukça sınırlı olup son yıllarda D-dimer testi ile ilgili çalışmalar yapılmaktadır. Bu prospektif çalışmada AMİ’nin tanısında ve akut pankreatit ve akut kolesistit’ten ayırıcı tanısında plazma D-dimer düzeyinin önemini araştırdık. Yöntemler: Acil servisimize karın ağrısı şikayeti ile baş- vuran 89 hastayı çalışmamıza dahil ettik. Hastaların sa- yısı ve tanıları sırasıyla 17 AMİ, 42 akut pankreatit ve 30 akut kolesistit şeklindeydi. Tüm hastaların plazma D-di- mer düzeylerini lateks aglütinasyon ‘ immunoassay ’ yön- temiyle ölçtük. Neticede D-dimer testinin AMİ tanısındaki duyarlık ve özgüllüğünü hesapladık. Bulgular: AMİ’nin özgüllüğü akut pankreatitten ayırıcı ta- nısında %50, akut kolesistitten ayırıcı tanısında %70, tüm kontrol gurubu için %58,3; duyarlığı %100 idi. Sonuç: AMİ’nin akut pankreatit ve akut kolesistitten ayı- rıcı tanısında plazma D-dimer konsantrasyonunun ölçü- mü yararlı olabilir. Ancak, D-dimerin tanısal değerini daha açık bir şekilde ortaya koyabilmek için eşik değerin yük- sek olarak belirlendiği ve ayırıcı tanıya giren diğer akut karın nedenlerinin de kontrol gurubuna katıldığı daha ge- niş serili çalışmalara ihtiyaç vardı

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Cite This Article

KOT, S., SARI, A., ÇETİN, K., DURAKER, N. (2016). The Value of D-Dimer in Diagnosis of Acute Mesenteric Ischemia and Differential Diagnosis from Acute Pancreatitis and Acute Cholecystitis. Dicle Tıp Dergisi, Cilt: 43 - Sayı: 1, 88–92. https://ajindex.com/articles/209750

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References (16)

  1. Kassahun WT, Schulz T, Richter O, Hauss J. Unchanged high mortality rates from acute occlusive intestinal ischemia: six year review. Langenbecks Arch Surg 2008; 393:163-171
  2. Yasuhara H. Acute mesenteric ischemia: The challenge of gastroenterology. Surg Today 2005;35:185-195
  3. Schneider TA, Longo WE, Ure T, Vernava AM. Mesenteric ischemia: Acute arterial syndromes. Dis Colon Rectum 1994;37:1163-1174
  4. Kaleya RN, Boley SJ. Acute mesenteric ischemia. Crit Care Clin 1995;11:479-512
  5. Brondt LJ, Boley SJ. AGA technical review on intestinal ischemia. American Gastrointestinal Association. Gastro- enterology. 2000;118:954-968
  6. Acosta S, Nilsson T. Current status on plasma biomarkers for acute mesenteric ischemia. J Thromb Thrombolysis 2012;33:355-361
  7. Acosta S, Nilsson TK, Björck M. D-dimer testing inpatients with suspected acute thromboembolic occlusion of the su- perior mesenteric artery. Br J Surg 2004;91:991-994
  8. Block T, Nilsson TK, Björck M, Acosta S. Diagnostic accu- racy of plasma biomarkers for intestinal ischemia. Scand J Clin Lab Invest 2008;68:242-248
  9. Thuijls G, van Wijck K, Grootjans J, et al. Early diagnosis of intestinal ischemia using urinary and plasma fatty acid binding proteins. Ann Surg 2011;253:303-308
  10. Gündüz A, Türkmen S, Turedi S, et al. Time-dependent variations in ischemia-modified albumin levels in mesen- teric ischemia. Acad Emerg Med 2009;16:539-543
  11. Kanda T, Fujii H, Tani T, et al. Intestinal fatty acid binding protein is a useful diagnostic marker for mesenteric infarc- tion in humans. Gastroenterology 1996;110:339-343
  12. Acosta S, Nilsson TK, Björck M. Preliminary study of D- dimer as a possible marker of acute bowel ischaemia. Br J Surg 2001;88:385-388
  13. Akyıldız H, Akcan A, Oztürk A, et al. The correlation of the D-dimer test and biphasic computed tomography with mes- enteric computed tomography angiography in the diagnosis of acute mesenteric ischemia. Am J Surg 2009;197:429- 433
  14. Chiu YH, Huang MK, How CK, et al. D-dimer in patients with suspected acute mesenteric ischemia. Am J Emerg Med 2009;27:975-979
  15. Yücedağ E, Uysal A, Burma O, et al. Comparison of ven- tilation/perfusion scintigraphy and multi-detector comput- erized tomography in diagnosis of asymptomatic pulmo- nary embolism after deep vein thrombosis. Dicle Med J 2014;41:179-186
  16. Duman A, Salt Ö, Özkan S, et al. Demographic character- istics of patients with pulmonary thromboembolism. J Clin Exp Invest 2015;6:10-15. 1