Multi-detector angio-CT and the use of D-dimer for the diagnosis of acute mesenteric ischemia in geriatric patients

Ulus Travma Acil Cerrahi Derg. 2014 Sep;20(5):376-81. doi: 10.5505/tjtes.2014.57639.

Abstract

Background: There is no specific laboratory method for the diagnosis of acute mesenteric ischemia (AMI). In this study, we aimed to determine the efficacy of the D-dimer test in selected cases prior to multi-detector angio-CT, which is expensive and has side effects.

Methods: Patients, over 65, with abdominal pain were included in this study. The D-dimer test was applied to 230 (34%) of 676 abdominal pain patients admitted to our emergency service. The D-dimer levels of the patients diagnosed with AMI by angio-CT were compared.

Results: In AMI patients sensitivity of the D-dimer test was 84.6% and the specificity was 47.9%. Elevated D-dimer levels and AF were observed in 90.9% of the patients diagnosed with AMI by CT.

Conclusion: D-dimer levels were elevated in the AMI patients. Patients suspected of having AMI with unclear clinical results and patients with D-dimer levels above 1000 ng/ml and AF should undergo further evaluation.

Publication types

  • Evaluation Study

MeSH terms

  • Abdomen, Acute / etiology
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood*
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism*
  • Geriatric Assessment
  • Health Services for the Aged
  • Humans
  • Male
  • Mesenteric Ischemia / blood
  • Mesenteric Ischemia / complications
  • Mesenteric Ischemia / diagnosis*
  • Mesenteric Ischemia / diagnostic imaging
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D