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Plasma citrulline measurement in the diagnosis of acute mesenteric ischaemia
Author(s) -
Kulu Rıdvan,
Akyildiz Hizir,
Akcan Alper,
Oztürk Ahmet,
Sozuer Erdogan
Publication year - 2017
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13524
Subject(s) - medicine , creatinine , citrulline , gastroenterology , procalcitonin , mesenteric ischemia , d dimer , glutamine , surgery , ischemia , arginine , amino acid , sepsis , biochemistry , chemistry
Background The differential diagnosis in acute mesenteric ischaemia ( AMI ) is essential and sometimes life‐saving. A marker for early diagnosis is lacking. Citrulline is an amino acid mainly synthesized by small bowel enterocytes from glutamine. In this study, we aimed to evaluate the diagnostic and prognostic values of citrulline with those of the D‐dimer in patients with AMI . Methods The patients were divided into two groups; group 1: patients with acute abdominal findings which were attributed preoperatively to AMI , and group 2: patients with acute abdominal findings which were attributed preoperatively to causes other than AMI . All patients underwent surgical exploration. Blood samples were taken before surgery. The demographic features, laboratory examinations, citrulline concentration, D‐dimer level and surgical findings were evaluated. Results Overall, 48 patients were enrolled in the study. AMI was diagnosed in 23 of the 48 patients. There was no significant difference between the groups with regard to gender, leucocyte count and creatinine levels but group 1 was significantly older than group 2. Citrulline, D‐dimer and lactate levels were also significantly higher in group 1. Age, lactate, D‐dimer and citrulline levels were statistically significant for mortality. The most significant factor was increased lactate level at admission. Conclusion Plasma citrulline level may be helpful in the diagnosis of patients with AMI .