Abstract
Purpose: The aims of this pilot study were to reveal the biological characteristics of serum I-FABP and explore its clinical utility as a biomarker in patients with small bowel obstruction (SBO). Methods: Serum I-FABP levels were measured in 37 consecutive patients with SBO between 2007 and 2008. Serum I-FABP levels were compared between ischemia (n = 10) and non-ischemia (n = 27) groups. Serum I-FABP levels were longitudinally analyzed in 21 patients who showed high (>2.0 ng/ml) serum I-FABP levels. The relationship between serum I-FABP level and length of damaged bowel was also analyzed. Results: Median serum I-FABP levels were 9.2 ng/ml in the ischemia group and 1.9 ng/ml in the non-ischemia group (p － 7.660, r = 0.604, p = 0.0018). By setting the cutoff level at 7.2 ng/ml, the diagnostic ability of serum I-FABP was 70.0% in terms of sensitivity, 92.6% in terms of specificity, and 86.5% in terms of accuracy. Conclusion: Serum I-FABP sensitively reflects bowel damage in SBO patients and seems to be a potential biomarker for detecting small-bowel ischemia.
Highlights
Small bowel obstruction (SBO) is one of the most common diseases in abdominal surgery
We divided the 37 enrolled small bowel obstruction (SBO) patients into ischemia (n = 10) and non-ischemia (n = 27) groups and compared the serum Intestinal fatty acid binding protein (I-FABP) levels of the two groups using the data at the time of diagnosis of SBO (Figure 1)
Temporal Changes of Serum I-FABP Levels Serum I-FABP levels were monitored in 36 patients with SBO, excluding one patient who postoperatively underwent hemodialysis
Summary
Small bowel obstruction (SBO) is one of the most common diseases in abdominal surgery. SBO associated with ischemia, i.e., strangulated obstruction of the small bowel, is a life-threatening condition. A delay in diagnosis can lead to irreversible full-thickness bowel necrosis that requires massive resection of the small bowel and is associated with a high risk of death [1]. Diagnosis of strangulated SBO is essential to improve both prognosis and quality of life of SBO patients. Advances in radiological imaging technology, including multidetector computed tomography (MDCT), have made it easier to diagnose strangulated SBO than before, the accurate diagnosis of strangulated SBO remains difficult even for diagnostic radiologists and experienced
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