Vengateshwar, R (2020) A Prospective study on Combination of Raised Serum C-Reactive Protein and D-Lactate as Useful Biomarkers in Prediction of Bowel Gangrene in Intestinal Obstruction. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.
|
Text
220101020vengateshwar.pdf Download (3MB) | Preview |
Abstract
INTRODUCTION: Intestinal obstruction is one of the commonest clinical problems in surgical practice. One of grave complication of intestinal obstruction is Strangulation requiring Resection & Anastomosis of involved bowel. Bowel ischemia occurs in 7 – 42 % of bowel obstruction. Bowel ischemia significantly increases mortality associated with bowel obstruction. TIME is an essence. Earlier diagnosis of strangulation favours increased patient survival rate. Diagnosis of strangulation is primarily clinical. Only few studies in human have been reported regarding the biomarkers of preoperative strangulation. AIM OF STUDY: To study on combination of raised serum c-reactive protein and d – lactate as useful biomarkers in prediction of bowel gangrene in intestinal obstruction. MATERIALS AND METHODS: Cases admitted to GMKMC hospital Salem with signs of intestinal obstruction in Emergency ward will be closely monitored from the day of admission to the day of discharge. On an average of 100 patients with signs of intestinal obstruction and strangulation admitted in emergency ward between 2017-2019. OBSERVATION: A Prospective Study on Combination of Raised Serum C - reactive protein and D – Lactate as Useful Biomarkers in Prediction of Bowel Gangrene in Intestinal Obstruction included 100 patients presenting with signs of intestinal obstruction and strangulation. All patients presenting with acute intestinal obstruction of were selected, serum CRP & D-lactate were taken pre operatively and their increase were correlated with per operative findings of bowel gangrene. The age distribution of the patients is given below. The mean age is 51.13 years with a standard deviation of 12.2 years. The majority of the patients were males (n=53, 53%) and the rest were females (n=47, 47%). Abdominal pain was seen in fifty patients (50%) and the rest did not have abdominal pain (n=80, 80%). Irreducible swelling was present in 40% (n=40) of the patients while the remaining (n=60, 60%) did not have irreducible swelling. The incidence of vomiting in patients was 52% (n=52) while 48% of them (n=48) did not have vomiting. Around 13% (n=13) cases presented with obstipation while the rest did not have obstipation. Abdominal distension was present in 48% (n=48) of the cases while the remaining 52% (n=52) did not have abdominal distension. Guarding was present in 60% (n=60) of the cases while the rest (n=40, 40%) did not have guarding or rigidity. The patients presenting with bowel sounds were 10% (n=10) while the rest (n=90, 90%) did not have bowel sounds. Majority of them had symptoms for more than 48 hours (n=62, 62%). Around 22% (n=22) of them had symptoms between 24-48 hours while the rest (n=16, 16%) had symptoms for less than 24 hours. Around 81% (n=81) did not have any history of previous surgery. The gangrene of the bowel was present in 31% (n=31) of the cases while the rest were normal (n=56, 56%) or pregangrenous state (n=13, 13%). The mean serum LDH was high (mean=869, S.D=192) and serum CRP was high (mean=126, S.D=29.87) in patients with gangrene. The serum LDH and Serum CRP are useful Biomarkers in Prediction of Bowel Gangrene in Intestinal Obstruction. CONCLUSION: Strangulation is the gravest outcome of the illness that might require an emergency procedure. Time is golden in the management of acute intestinal strangulation. Earlier is the diagnosis and intervention, better is the prognosis. The diagnosis of strangulation depends on the clinical evaluation and the expertise of the team evaluating the patient. The serum LDH and Serum CRP are useful Biomarkers in Prediction of Bowel Gangrene in Intestinal Obstruction.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221711410 |
| Uncontrolled Keywords: | Intestinal Obstruction, Bowel Gangrene, C-Reactive Protein (CRP), Lactate Dehydrogenase. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 12 Feb 2021 16:11 |
| Last Modified: | 12 Feb 2021 16:11 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14058 |
Actions (login required)
 |
View Item |
