Base Excess and White Blood Cell Counts Predict Bowel Gangrene in Japanese Sigmoid Colon Volvulus Patients

Abstract

Objective: This study aimed to investigate factors that predict bowel gangrene in sigmoid colon volvulus patients. Methods: Nine sigmoid colon volvulus cases were retrospectively analyzed for prediction of bowel necrosis. Laboratory parameters were extracted from medical records, and subsequently, a receiving operator curve for each parameter was drawn. Using these cut-off values, a comparison between the “with necrosis” and “without necrosis” groups was performed. Results: In the emergent cases, necrosis of the intestine was observed in 4 cases and not observed in 4 cases. The values of area under the curve were high in metabolic acidosis and white blood cell counts. For base excess, the cut off value was -2.4 mEq/L. A lower base excess is significantly associated with bowel gangrene (p = 0.029). For white blood cell count, the cut off value is 8400/mm3. A lower white blood cell counts is significantly associated with bowel gangrene (p = 0.029). Conclusions: In addition to physiological findings, blood gas analysis and white blood cell counts are useful to detect ischemia due to sigmoid volvulus.