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Medline ® Abstract for Reference 37

of 'Overview of intestinal ischemia in adults'

Usefulness of plasma lactate concentration in the diagnosis of acute abdominal disease.
Lange H, Jäckel R
Eur J Surg. 1994;160(6-7):381.
OBJECTIVE: To verify the diagnostic importance of the plasma lactate concentration in acute abdominal disease and to examine its role as a marker of mesenteric ischaemia.
DESIGN: Prospective study.
SETTING: Two departments of surgery, one in Sweden and one in Germany.
SUBJECTS: 85 patients with acute abdominal symptoms.
MAIN OUTCOME MEASURES: Correlation between the plasma lactate concentration before operation or (in the case of those not operated on) before the diagnosis was established, and the final diagnosis.
RESULTS: Plasma lactate concentrations exceeded the reference range in all cases of mesenteric ischaemia (n = 20) and general bacterial peritonitis (n = 15) and in half of the 20 cases of intestinal obstruction. They were also raised in 3 of 10 cases of acute pancreatitis.
CONCLUSIONS: A raised plasma lactate concentration is always a sign of an acute life-threatening condition, and usually indicates the need for an emergency operation. As a marker of mesenteric ischaemia its sensitivity was 100% and its specificity 42%. We conclude that a raised serum lactate concentration is the best marker of mesenteric ischaemia to date.
Surgical Department Hospital, Köping, Sweden.