Evaluation of the role of Serum Lactate as a predictor of intestinal ischemia and exploration in Adhesive Intestinal Obstruction in pediatrics

Ahmed F. Sanad, (M.B.B.ch), Mansoura University, Resident in Pediatric Surgery Department, Mansoura University Children Hospital, EgyptFollow
Adham ELsaied, Professor of Pediatric Surgery Faculty of Medicine, Mansoura University, Egypt
Ahmed Shehta, Professor of Gastroenterology Surgery Faculty of Medicine, Mansoura University, Egypt
Ahmad ELHATTAB, Lecturer of pediatric surgery Faculty of Medicine, Mansoura University, Egypt

Subject Area

Pediatric Surgery

Article Type

Original Study

Abstract

Background: Adhesive small bowel obstruction (ASBO) is a common surgical Problem in children. It sometimes occurs when there are adhesions between bowel loops, it can be treated with conservative management through nasogastric tube (NGT) decompression and upper gastrointestinal contrast study or managed with surgical intervention if conservative management fails. Methods: Our study is a prospective cohort one that included 51 patients diagnosed with ASBO. They were divided into two groups based on whether they were managed conservatively (Group A) or underwent exploration (Group B), Group B was further subdivided into 2 groups: Group B1, including explored cases without resection anastomosis and Group B2, including patients who underwent resection anastomosis. Serum lactate was withdrawn to all of them on admission after initial fluid resuscitation. Results: Serum lactate levels demonstrated a statistically significant difference among the studied groups. When comparing the conservative management group (Group A) with the exploratory surgery group (Group B), serum lactate levels were significantly higher in Group B, with a mean value of 20.29 ± 6.22 mg/dl, compared with 17.30 ± 2.86 mg/dl in Group A (p = 0.009). Furthermore, serum lactate showed a cutoff value of 24 mg/dl (p = 0.004) for differentiating ischemic from non-ischemic cases among patients undergoing exploration. These findings suggest that serum lactate is a reliable indicator of intestinal ischemia in patients with ASBO. Conclusions: Serum lactate showed limited discriminatory ability for predicting the need for surgical exploration in pediatric adhesive small bowel obstruction. However, among patients undergoing exploration, serum lactate demonstrated promising discriminatory ability for identifying cases requiring bowel resection and anastomosis.

Serum lactate may therefore serve as an adjunctive marker of intestinal ischemia when interpreted alongside clinical findings, although the observed cutoff requires validation in larger studies

Recommended Citation

Sanad, Ahmed F.; ELsaied, Adham; Shehta, Ahmed; and ELHATTAB, Ahmad (2026) "Evaluation of the role of Serum Lactate as a predictor of intestinal ischemia and exploration in Adhesive Intestinal Obstruction in pediatrics," Mansoura Medical Journal: Vol. 56 : Iss. 2 , Article 17.
Available at: https://doi.org/10.58775/2735-3990.1619