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Likelihood Ratio (LR) in Emergency Medicine

11/23/2011

Intestinal Ischemia and Lactate

A 84 y/o woman comes accompained by relatives for abdominal pain.
She is oriented and cooperative, she suffers pain (NRS 10/10).
Abdomen is treatable, but very painful in the lower quadrants, you see green watering diarrhea, she has not fever.
Abdominal Radiograph shows air/fluid levels
WBC: 35000/μl PCR: 22 mg/L Lactate: 1,7


Can you rule out intestinal ischemia?









Conclusion 

The performance of lactate and other serological markers is disappointing and not particularly helpful to rule out intestinal ischemia.


Bibliography 

NJ Evennett, MS Petrov, A Mittal, JA Windsor
Systematic Review and Pooled Estimates for the Diagnostic Accuracy of Serological Markers for Intestinal Ischemia
World J Surg (2009) 33:1374–1383 


Ilenia Spallino

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