Diagnosis of strangulated bowel obstruction using blood DNA-degrading enzyme activity

Abstract

Strangulated bowel obstruction (StBO) is an abdominal emergency that can be fatal if left untreated. However, it can be difficult to diagnose due to a lack of consensus regarding the diagnosis of StBO based on blood biochemistry or arterial blood gases, inconsistencies with imaging used in diagnosis and a lack of definitive features that definitively point to StBO. Assistant Professor Takuma Iwai, Nippon Medical School, Japan, is leading a team of researchers developing a novel method to easily diagnose StBO using peripheral blood. This will help with diagnosis, improve outcomes and save lives. In this work, Iwai is applying his longstanding experience in laparoscopic surgery and chemotherapy for gastrointestinal cancers. The researchers are investigating how Cell-free DNA (cfDNA) can be used in StBO diagnosis. This began with research on the treatment of colorectal cancer utilising cfDNA, which led to the discovery that the length of cfDNA fragments present in blood is indicative of various forms of cellular death â–“ and that variations in DNA fragment length also result in differences in enzymatic degradation activity. This led Iwai and the team to posit that cfDNA may also prove beneficial in the diagnosis of StBO, which is characterised by a disturbance in blood flow.