Role of Intestinal Fatty Acid Binding Protein in Diagnosing Adhesive Small Bowel Obstruction: A Pilot Study.

IF 1.2 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2025-08-14 DOI:10.1159/000547989

Juliette S van Dam, Claire A J I Leenarts, Thijs R van Oudheusden, Joep P M Derikx, Misha Luyer

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引用次数: 0

Abstract

Introduction: The incidence of adhesive small bowel obstruction (ASBO) after abdominal surgery is 2.4%. Delay in surgery increases morbidity and mortality. Plasma intestinal fatty acid binding protein (I-FABP) levels indicate intestinal damage and may guide treatment. The aim of this study was to investigate whether plasma I-FABP levels may optimize selection of patients requiring surgery presenting with ASBO.

Methods: Patients with suspected ASBO underwent a contrast swallow. If bowel transit was absent after 8 h, surgery was performed. I-FABP levels were assessed at several moments. Data were analyzed by comparing groups based on bowel transit, ischemia, and positive or negative laparotomies. Furthermore, a true operative group (patients with mechanical obstruction during surgery and patients needing operative treatment who deceased due to non-operative treatment) was compared to a true non-operative group (patients with negative laparotomies and patients successfully treated with non-operative treatment).

Results: Median I-FABP levels were higher in patients without bowel transit (1,207 pg/mL) than in patients with bowel transit (589 pg/mL, p = 0.01). Median I-FABP levels in the negative laparotomy group (301 pg/mL) showed a trend to significance compared to the positive laparotomy group (1,177 pg/mL, p = 0.05). There was no significant difference between the true operative group (1,150 pg/mL) and the true non-operative group (664 pg/mL) or between proven ischemia (975 pg/mL) and no ischemia (921 pg/mL).

Conclusion: I-FABP might help identify ASBO patients in whom surgery can be postponed.

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肠脂肪酸结合蛋白在粘连性小肠梗阻诊断中的作用：一项初步研究。

腹部手术后粘连性小肠梗阻（ASBO）的发生率为2.4%。手术延误会增加发病率和死亡率。血浆肠脂肪酸结合蛋白（I-FABP）水平提示肠损伤，可能指导治疗。本研究的目的是探讨血浆I-FABP水平是否可以优化需要手术的患者的选择。疑似ASBO患者行对比吞咽检查。如8小时后仍未肠通，则行手术。评估I-FABP水平。通过肠转运、缺血和剖腹手术阳性或阴性的比较组来分析数据。此外，将真手术组（术中机械性梗阻患者和因非手术治疗而死亡的需要手术治疗的患者）与真非手术组（阴性剖腹手术患者和非手术治疗成功的患者）进行比较。无肠转运患者I-FABP水平中位数（1207 pg/mL）高于肠转运患者（589 pg/mL, P = 0.01）。剖腹阴性组中位I-FABP水平（301 pg/mL）较剖腹阳性组（1177 pg/mL, P = 0.05）有统计学意义。真手术组（1150 pg/mL）与真非手术组（664 pg/mL）、证实缺血组（975 pg/mL）与未缺血组（921 pg/mL）之间无显著差异。综上所述，I-FABP可能有助于识别可以推迟手术的ASBO患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.