A prospective study of serum C-reactive protein and D-lactate levels for early prediction of strangulation in intestinal obstruction

Abstract

Background: Intestinal obstruction is one of the commonest clinical problems encountered in surgical practice. One of the grave complications of intestinal obstruction is strangulation, which requires an emergency laparotomy for management. This study was conducted to emphasise the significance of early estimation of rise in serum C-reactive protein and D- lactate levels.Methods: Hospital based prospective study was performed on 50 patients admitted in J.L.N. Hospital, Ajmer in various surgical units with diagnosis of acute intestinal obstruction and underwent explorative Laparotomy.Results: CRP test sensitivity was 85.00%, specificity was 80.67%, PPV was 73.91% and NPV was 88.89% to detected the obstruction with strangulation when using a cutoff value of 60 mg/L. D-lactate test sensitivity was 80.00%, specificity was 90.00%, PPV was 84.30% and NPV was 87.10% to detected the obstruction with strangulation when using a cutoff value of 4.5 mmol/L.Conclusions:Serum CRP and D-lactate can be useful and reasonable markers for predicting strangulation in cases of acute intestinal obstruction in an emergency setting.