THE ROLE OF PLASMA D-DIMER LEVELS IN PATIENTS WITH ACUTE MESENTERIC ISCHEMIA

Aim: We designed this study to determine whether the fibrinolytic marker D-dimer is a useful early marker of acute mesenteric ischemia. Methods: We measured plasma D-dimer levels in 25 patients presenting with severe abdominal pain, in addition to 10 healthy controls. Based on laparotomy findings, patients were categorized into those with acute mesenteric ischaemia (AMI)(15 patients) and those without acute mesenteric ischaemia (NAMI) (10 patients). Results: We demonstrated significant increase of plasma D-dimer level in AMI group compared to NAMI group (P 0.01). Furthermore, plasma D-dimer level was significantly elevated in NAMI group compared to controls (P 0.001). Conclusion: Plasma D-dimer 3.8 ug/ml combined with relevant clinical variables has a high positive predictive value for early identification of patients with AMI. However, plasma D-dimer 0.53 ug/ml has a high negative predictive value for AMI and could be used as an exclusion test. This, strategy could aid in the decision for urgent surgery with subsequent improvement of the surgical outcome