Role of Arterial Blood Levels of Serum Lactate as a Biomarker of Intestinal Ischemia in Patients of Intestinal Obstruction

Background: Intestinal obstruction is a common surgical emergency. Strangulated obstruction may result in bowel ischemia, leading to significant morbidity and mortality. Early identification of ischemia is critical. This study evaluates arterial blood levels of serum lactate as a biomarker for predicting intestinal ischemia in patients presenting with intestinal obstruction. Methods: A cross -sectional observational study was conducted over one year on 60 patients presenting with clinical features of intestinal obstruction requiring surgery. Serum lactate levels were measured preoperatively and 24 hours postoperatively. The association of lactate levels with intraoperative findings of bowel ischemia was analyzed using ROC curve analysis. Results: Bowel ischemia was identified in 16.7% (10/60) of cases. Mean preoperative serum lactate was significantly higher in patients with bowel ischemia (3.25 1.46 mmol/L) compared to those without (1.22 0.41 mmol/L, p<0.01). ROC curve analysis revealed an area under the curve (AUC) of 0.95 with a lactate cut -off value of 2.32 mmol/L yielding 90% sensitivity and 96% specificity. Conclusion: Arterial serum lactate is a reliable, accessible, and cost -effective biomarker for early identification of intestinal ischemia in patients with intestinal obstruction. A level above 2.32 mmol/L significantly correlates with ischemic changes.