Role of procalcitonin in predicting the bowel gangrene and ischemia in acute intestinal obstruction

Abstract

Background: Acute intestinal obstruction being the most common presentation on intestinal ischaemia and bowel gangrene. This study mainly concentrated on need for new marker for early prediction mesenteric ischaemia. Procalcitonin as a marker for stoppage of conservative management in intestinal obstruction. Methods: Out 70 patients 45 underwent conservative and 25 eventually underwent surgery (midline laparotomy). Procalcitonin levels in both are observed at regular intervals and compared and analysis done using appropriate statistical tests. Results: Level of procalcitonin was found to be higher in patients who need surgery consistantly when compared with those who were in conservative line of management with mean PCT level 2.19 and 2.23 in conservative line with mean PCT of 3.68 and 6.58 for surgical need at presentation and after 48 hrs respectively with p value <0.0001 which is significant. Conclusions: PCT at presentation can be a very good tool for predicting the bowel ischaemia and gangrene as an early indicator and also it can be used as a marker for need for surgery in patients managing conservatively for intestinal obstruction.