Observational study to predict gut gangrene from raised serum C reactive protein levels in intestinal obstruction cases

Background: Intestinal obstruction can progress to bowel gangrene, increasing morbidity and mortality. Early diagnosis and decision taking for intervention remains challenging. This study evaluated serum C-reactive protein (CRP) as a predictive marker for gangrene in intestinal obstruction. Methods: A prospective observational study was conducted on 110 patients with surgically managed intestinal obstruction at SMS Hospital, Jaipur. Serum CRP levels at admission were recorded and correlated with intraoperative findings. Statistical analysis included ROC curve for determining predictive value. Results: Bowel gangrene was found in 30% of cases. Mean CRP levels were significantly higher in gangrene cases (121 mg/l) vs. non-gangrene (12 mg/l) (p<0.001). A CRP cut-off of 43.05 mg/l showed 93.9% sensitivity and 96.1% specificity. Delays >48 hours from symptom onset to surgery significantly increased gangrene risk (p=0.008). Conclusions: Serum CRP is a valuable, accessible biomarker for early detection of gut gangrene in intestinal obstruction, aiding timely surgical intervention. Further studies with serial CRP measurements are recommended.