Early Diagnosis of Intestinal Ischemia Using Urinary and Plasma Fatty Acid Binding Proteins

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Excerpt

Acute intestinal ischemia is a severe intestinal emergency with high mortality.1 It can be precipitated by a number of pathophysiological processes such as arterial embolism, arterial and venous thrombosis, aortic dissection, intestinal obstruction due to adhesive diseases after previous operations, and nonocclusive disorders (eg, hypovolemia, hypotension). Clinical diagnosis of intestinal ischemia remains difficult, because of the nonspecific clinical signs in the early phase. Especially, in high-risk patients clinical history taking and physical examination is hampered because of sedation and analgesia. In addition, the lack of appropriate diagnostic tests further hampers correct diagnosis.2 In most patients, intestinal ischemia is recognized only when the patient has extensive transmural necrosis or sepsis. Delayed diagnosis is a major reason for the high-mortality rates of intestinal ischemia, because a diagnostic delay of 24 hours decreases survival rates by more than 20%.1 Therefore, it is important to improve early diagnosis of intestinal ischemia.
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