Base Excess and White Blood Cell Counts Predict Bowel Gangrene in Japanese Sigmoid Colon Volvulus Patients
- 1 Department of Surgery I, Dokkyo Medical University, Mibu, Japan
- 2 Department of Surgery I, Dokkyo Medical University, Mibu, Japan
- 3 Department of Surgery I, Dokkyo Medical University, Mibu, Japan
- 4 Department of Surgery I, Dokkyo Medical University, Mibu, Japan
- 5 Department of Surgery I, Dokkyo Medical University, Mibu, Japan
- 6 Department of Surgery I, Dokkyo Medical University, Mibu, Japan
- 7 Department of Surgery I, Dokkyo Medical University, Mibu, Japan
- 8 Department of Surgery I, Dokkyo Medical University, Mibu, Japan
- 9 Department of Surgery I, Dokkyo Medical University, Mibu, Japan
- 10 Department of Surgery I, Dokkyo Medical University, Mibu, Japan
Abstract
Objective: This study aimed to investigate factors that predict bowel gangrene in sigmoid colon volvulus patients. Methods: Nine sigmoid colon volvulus cases were retrospectively analyzed for prediction of bowel necrosis. Laboratory parameters were extracted from medical records, and subsequently, a receiving operator curve for each parameter was drawn. Using these cut-off values, a comparison between the “with necrosis” and “without necrosis” groups was performed. Results: In the emergent cases, necrosis of the intestine was observed in 4 cases and not observed in 4 cases. The values of area under the curve were high in metabolic acidosis and white blood cell counts. For base excess, the cut off value was - 2.4 mEq/L. A lower base excess is significantly associated with bowel gangrene (p = 0.029). For white blood cell count, the cut off value is 8400/mm 3 . A lower white blood cell counts is significantly associated with bowel gangrene (p = 0.029). Conclusions: In addition to physiological findings, blood gas analysis and white blood cell counts are useful to detect ischemia due to sigmoid volvulus.
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