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Likelihood Ratio (LR) in Emergency Medicine


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?


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


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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