J Korean Soc Emerg Med.  2000 Dec;11(4):457-463.

Usefulness of Serum Lactate in the Early Diagnosis of Intestinal Ischemia

• Lee MJ
• Oh DR
• Park KN
• Kim SK
• Yang JH
• Park SH

Abstract

BACKGROUND: Intestinal ischemia remains a devastating event despite improvements in clinical recognition and in diagnostic and therapeutic modalities. The ischemic bowel diseases encompass a wide clinical spectrum from mild, reversible disease to severe, irreversible injury. The clinical picture is characterized initially by poorly localized whether an increased serum lactate level is a recognized danger signal marker for intestinal ischemia in patients who present at the emergency department because of abdominal complaints.
METHODS
Patients who came to our emergency department with abdominal pain and the risk factors of intestinal ischemia between Apr. 1999 and Nov. 1999 were included in this study. The data analysis included age, sex, final diagnosis, pathogenesis of bowel ischemia, and serum lactate level.
RESULTS
The serum lactate level in the intestinal ischemia group was 28.54+/-22.51mg/dl; in non-ischemia group, it was 15.49+/-22.52mg/dl. This difference between the two groups was significatn(p<0.05). An increased serum lactate level had a sensitivity of 88.2% and specificity of 59.2%, a positive likelihood ratio of 4.92, and a negative likelihood ratio of 0.47 as a marker of bowel ischemia. These results do not represent a very meaningful revision of bowel ischemic provability, but may make a small contribution to management of the disease, depending upon their magnitude and the clinical context in which they are applied.
CONCLUSION
In patients with abdominal complaints, an increased serum lactate level is usually a useful aid as a diagnostic marker of bowel ischemia.

MeSH Terms

Abdominal Pain
Diagnosis
Early Diagnosis*
Emergency Service, Hospital
Humans
Ischemia*
Lactic Acid*
Risk Factors
Sensitivity and Specificity
Statistics as Topic
Lactic Acid