Joe Praveen Kumar, J (2020) A Study on Assessment of Serum Lactate Levels in Intestinal Obstruction. Masters thesis, Stanley Medical College, Chennai.
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Abstract
AIM AND OBJECTIVE: To evaluate role of serum lactate as a marker of strangulation in intestinal obstruction. METHODS: During the time period of February 2019 to July 2019, 50 patients of age group more than 12 years and both sex with clinical suspicion of acute intestinal obstruction who are admitted in the emergency ward in the department of general surgery, Government Stanley medical college, Chennai. Blood samples for serum lactate taken within 20 minutes of presentation. Assessment of serum lactate levels in various outcomes of acute intestinal obstruction is done. RESULTS: Among those patients, 96% were small bowel obstruction and 4% were large bowel obstruction. About 36% had previous history of surgery of which 6% had postoperative adhesions causing obstruction or strangulation. Hernia and adhesions were the common etiologies noted. Out of 50 patients, 72% had strangulation and bowel gangrene and the rest were simple obstructions. The cut off values of serum lactate levels for strangulation, strong suspicion and subacute obstruction managed conservatively were 4.3,3.4 and 2.3 respectively. Based on these values, 72% were classified as strangulation, 22% with strong suspicion and 6% were normal. Comparison of serum lactate values across these groups with normal, strong suspicion and strangulation shows that the results are highly significant p=0.00123. CONCLUSION: This study establishes a positive correlation between elevated serum lactate and strangulation. It would help in reducing the time interval to surgery in cases of acute intestinal obstruction with strangulation as well as decreasing unwarranted laparotomy in those cases of intestinal obstruction without strangulation that can be managed conservatively. This study does add to the current literature regarding the need of decision making policy for management of acute intestinal obstruction incorporating the role of biomarkers for predicting strangulation at the time of presentation.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711053 |
| Uncontrolled Keywords: | Assessment, Serum Lactate Levels, Intestinal Obstruction. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 09 Feb 2021 01:06 |
| Last Modified: | 09 Feb 2021 01:06 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13940 |
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