Back to Search
Start Over
The role of citrulline, intestinal fatty acid–binding protein, and D-dimer as potential biomarkers in the diagnosis of internal herniation after Roux-en-Y gastric bypass
- Source :
- Surgery for Obesity and Related Diseases. 17:1704-1712
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Diagnosing internal herniation (IH) in Roux-en-Y gastric bypass (RYGB) patients with acute abdominal pain poses a diagnostic challenge. Diagnostic laparoscopy is often required for a definitive diagnosis. We hypothesized that intestinal ischemia biomarkers would aid in the diagnosing of IH.To explore intestinal ischemia biomarkers in diagnosing IH.University Hospital, Sweden.Prospective inclusion of 46 RYGB patients admitted for acute abdominal pain between June 2015 and December 2017. Blood samples for analysis of citrulline, intestinal fatty acid-binding protein (I-FABP), and D-dimer were drawn72 hours from admission and compared between patients with IH (n = 8), small bowel obstruction (SBO) (n = 5), other specified diagnoses (n = 12), or unspecified abdominal pain (n = 21). Levels of white blood cell count (WBC), C-reactive protein (CRP), and lactate at admission were compared. A prospective pain questionnaire for time of pain onset and level of pain at onset and at admission was analyzed.None of the investigated biomarkers differed significantly between diagnosis categories. Most patients with IH had normal CRP, WBC, and D-dimer levels while their lactate levels were significantly lower (P = .029) compared with the rest of the cohort. Neither pain level nor pain duration differed between the groups.This study shows that citrulline, I-FABP, and D-dimer cannot be used to diagnose IH and indicates that CRP, D-dimer, and lactate are rarely elevated by an IH. Furthermore, pain intensity and duration cannot differentiate patients with IH. A diagnostic laparoscopy remains the gold standard to diagnose and rule out an IH.
- Subjects :
- medicine.medical_specialty
Abdominal pain
Gastric bypass
Gastric Bypass
030209 endocrinology & metabolism
Fatty Acid-Binding Proteins
Gastroenterology
Fibrin Fibrinogen Degradation Products
03 medical and health sciences
chemistry.chemical_compound
Postoperative Complications
0302 clinical medicine
Internal medicine
D-dimer
Citrulline
medicine
Humans
Prospective Studies
Retrospective Studies
business.industry
Gold standard (test)
Roux-en-Y anastomosis
Abdominal Pain
Obesity, Morbid
Surgery
chemistry
Intestinal Fatty Acid-Binding Protein
Cohort
Laparoscopy
030211 gastroenterology & hepatology
medicine.symptom
business
Biomarkers
Subjects
Details
- ISSN :
- 15507289
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Surgery for Obesity and Related Diseases
- Accession number :
- edsair.doi.dedup.....b31b9634b10082cac55337c8c29123c7