Can inflammatory markers predict intestinal wall ischemia in sigmoid volvulus?

Abstract

Aims: Sigmoid volvulus (SV), which causes closed-loop obstruction as a result of the rotation of the sigmoid colon around its mesentery, causes serious morbidity and mortality, especially in elderly patients, when necrosis develops in the intestine. In this study, it was investigated whether inflammatory markers, which guide the diagnosis and prognosis of many intra-abdominal pathologies, can predict the presence of ischemia in the intestine in patients with SV. Methods: In the study, patients who were operated on for SV in our clinic between January 2019 and March 2022 were retrospectively screened, and the demographic, clinicopathological, and laboratory parameters of the patients were examined. Data were analyzed with the Student’s T test and Mann-Whitney U-test. Results: Of the 47 patients included in the study, 28 (59.6%) were male and 19 (40.4%) were female. Intestinal necrosis was detected in 23 (48.9%) patients who underwent surgery. The mean age of the patient population was 70 (±19). There was no statistical difference between the two groups according to age (p=0.338). White blood cell count (WBC) (p=0.686); Neutrophil count (p=0.949); Lymphocyte count (p=0.790); Monocyte count (p=0.898); Neutrophil-lymphocyte ratio (NLR) (p=0.733); Platelet count (p=0.766); RDW value (p=0.725); There was no statistically significant difference between the two groups in lactate level (p=0.289), C-reactive protein (CRP) (p=0.212), Amylase (p=0.975) and Lactate dehydrogenase (LDH) (p=0.974) levels. Conclusion: Detection of intestinal necrosis is a vital condition for the patient. Inflammatory biomarkers obtained from preoperative routine blood parameters were not found to be significant in estimating the presence of intestinal necrosis in the SV clinic. It was concluded that large series are needed in this regard.