Normal Lactate and Unenhanced CT-Scan Result in Delayed Diagnosis of Acute Mesenteric Ischemia

Am J Gastroenterol. 2020 Nov;115(11):1902-1905. doi: 10.14309/ajg.0000000000000836.

Abstract

Introduction: To investigate the factors associated with a delayed diagnosis (DD) of acute mesenteric ischemia (AMI).

Methods: An observational cohort study from an intestinal failure center. The primary outcome was DD >24 hours.

Results: Between 2006 and 2015, 74 patients with AMI were included and 39 (53%) had a DD. Plasma lactate <2 mmol/L (odd ratio: 3.2; 95% confidence interval: 1.1-9.1; P = 0.03) and unenhanced computed tomography scan (odds ratio: 5.9; 95% confidence interval: 1.4-25.8; P = 0.01) were independently associated with DD.

Discussion: Suspicion of AMI should no longer be affected by normal plasma lactate levels and should prompt evaluation by a contrast-enhanced computed tomography-scan.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Pain / physiopathology
  • Acute Disease
  • Adult
  • Anastomosis, Surgical
  • Chronic Disease
  • Cohort Studies
  • Colon / surgery
  • Contrast Media*
  • Delayed Diagnosis / statistics & numerical data*
  • Early Diagnosis
  • Early Medical Intervention
  • Female
  • Humans
  • Intestine, Small / surgery
  • Jejunostomy
  • Lactic Acid / blood*
  • Male
  • Mesenteric Ischemia / blood
  • Mesenteric Ischemia / diagnostic imaging*
  • Mesenteric Ischemia / physiopathology
  • Mesenteric Ischemia / surgery
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Short Bowel Syndrome
  • Tomography, X-Ray Computed / methods*
  • Vomiting / physiopathology

Substances

  • Contrast Media
  • Lactic Acid