The effectiveness of gastric tonometry in the diagnosis of acute mesenteric ischemia in cases where a contrast-enhanced computed tomography cannot be obtained

Abstract

Objective: The aim of the study was to evaluate the effectiveness of gastric tonometry in the diagnosis of acute mesenteric ischemia in cases where a contrast-enhanced computed tomography cannot be obtained. Material and Methods:The gastric pH (pHi) and gastric CO 2 (gpCO 2 ) were measured with gastric tonometry catheter, preoperatively and postoperatively at 24 hours, in patients with suspicion of acute mesenteric ischemia. Simultaneous evaluation of blood gases and blood lactate levels were performed. Patients were divided into two groups after surgery. Group 1 included patients with mesenteric ischemia, and Group 2 consisted of patients without mesenteric ischemia.Results: Forty-two patients (26 males, 16 females) were evaluated. The mean age was 61.4±13.3 years. There was no significant difference between the groups in terms of demographic factors and co-morbid diseases. There were no significant differences between groups in terms of pHi and gpCO 2 levels (7.24±0.2 and -3±12.0 in Group 1, 7.18±0.06 and -3±1.9 in Group 2, respectively), intra-abdominal pressure, lactate levels, and survival. Among all the study parameters, only arterial pH had statistical significance in the diagnosis of acute mesenteric ischemia (7.23±0.21 versus 7.35±0.07 for Groups 1 and 2, respectively,) (p<0.05). Conclusion:Gastric tonometry is not a useful method in the early diagnosis of acute mesenteric ischemia.

Impairment of Mesenteric Perfusion as a Marker of Major Bleeding in Trauma Patients

“…Nonetheless, beyond equivocal reputation, the technique has some practical disadvantages that can hardly be bypassed. Most importantly, the time interval needed for gases to reach equilibrium can be a major hurdle in the emergency setting [117,118]. As well as being time consuming, tube placement can also be an issue of concern.…”