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  • Title: Preliminary study of D-dimer as a possible marker of acute bowel ischaemia.
    Author: Acosta S, Nilsson TK, Björck M.
    Journal: Br J Surg; 2001 Mar; 88(3):385-8. PubMed ID: 11260104.
    Abstract:
    BACKGROUND: Occlusion of the superior mesenteric artery (SMA) demands prompt recognition and diagnosis. No accurate diagnostic method is available. The aim of this study was to determine whether the fibrinolytic marker D-dimer is a useful early marker of acute bowel ischaemia. METHODS: Fourteen patients suspected of having acute bowel ischaemia were analysed for an increase in plasma D-dimer level. RESULTS: Six patients had embolic or thrombotic occlusion of the SMA and all had significantly higher D-dimer levels than those without thromboembolic occlusion (P < 0.05). Four patients with strangulation of the small bowel due to adhesions and one with a ruptured aortic aneurysm also had raised D-dimer values. CONCLUSION: In patients with suspected thromboembolic occlusive disease of the SMA, a raised level of D-dimer indicated the presence of acute bowel ischaemia, whatever the cause. A more extensive prospective study is needed to evaluate a potential survival benefit using the test as a marker of the need for urgent laparotomy.
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