Document Detail

D-dimer testing in patients with suspected acute thromboembolic occlusion of the superior mesenteric artery.
MedLine Citation:
PMID:  15286959     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There is no accurate non-invasive method available for the diagnosis of acute thromboembolic occlusion of the superior mesenteric artery (SMA). The aim of this study was to assess the diagnostic properties of the fibrinolytic marker D-dimer. METHODS: From September 2000 to April 2003 consecutive patients aged over 50 years admitted to hospital with acute abdominal pain were studied. Patients with possible acute SMA occlusion at presentation had blood samples taken within 24 h of the onset of the pain for analysis of D-dimer, plasma fibrinogen, activated partial thromboplastin time, prothrombin time and antithrombin. The value of D-dimer testing to diagnose SMA occlusion was assessed by means of likelihood ratios. RESULTS: Nine of 101 patients included had acute SMA occlusion. The median D-dimer concentration was 1.6 (range 0.4-5.6) mg/l, which was higher than that in 25 patients with inflammatory disease (P = 0.007) or in 14 patients with intestinal obstruction (P = 0.005). The combination of a D-dimer level greater than 1.5 mg/l, atrial fibrillation and female sex resulted in a likelihood ratio for acute SMA occlusion of 17.5, whereas no patient with a D-dimer concentration of 0.3 mg/l or less had acute SMA occlusion. CONCLUSION: D-dimer testing may be useful for the exclusion of patients with suspected acute SMA occlusion.
S Acosta; T K Nilsson; M Björck
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  91     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-08-02     Completed Date:  2004-08-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  991-4     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2004 British Journal of Surgery Society Ltd.
Department of Surgery, Uppsala University Hospital, Uppsala, Sweden.
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MeSH Terms
Abdominal Pain / etiology*
Aged, 80 and over
Fibrin Fibrinogen Degradation Products / analysis*
Mesenteric Artery, Superior*
Mesenteric Vascular Occlusion / diagnosis*
Middle Aged
Sensitivity and Specificity
Thromboembolism / diagnosis*
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D

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