%0 Journal Article
%T Ischemia Modified Albumin Can Predict Necrosis at Incarcerated Hernias
%A H¨¹seyin Kadio£¿lu
%A Dilek £¿m¨¹r
%A S¨¹leyman Bozkurt
%A Ekrem Ferlengez
%A Naim Memm£¿
%A Yeliz Emine Ersoy
%A G£¿khan £¿£¿pe
%A Mahmut M¨¹sl¨¹mano£¿lu
%J Disease Markers
%D 2013
%R 10.1155/2013/185425
%X Purpose. To evaluate the predictive effect of IMA in incarcerated hernias. Methods. Three groups ( ) of rats were operated. Group I aimed to mimic incarceration, group II aimed the strangulation, and group III was the sham group. IMA and LDH measurements were made. Results. IMA levels were significantly higher in strangulation mimicking group and IMA levels were normal at postoperative 6th hour in incarceration mimicking group. LDH levels were significantly higher in both incarceration and strangulation mimicking groups. Conclusion. IMA seems to be an effective marker in incarcerated hernias to predict necrosis. But we need further studies to generalise this hypothesis. 1. Introduction Among all emergency cases the ratio of incarcerated/strangulated hernias differs across the countries. But it is well known that hernia is the common cause of small bowel obstruction, and mortality and morbidity rates increase in case of strangulation. During acute ischemic conditions, metal binding capacity of albumin is modified and a metabolic variant with reduced transition metal binding occurs. This change is quantifiable and commonly known as ischemia modified albumin (IMA). Recently, IMA measurement has been proposed as a sensitive marker for the diagnosis of myocardial ischemia presenting with typical acute chest pain [1]. However, IMA levels are also known to increase in other ischemic conditions, as well as to be an indicator of oxidative stress, and may not be specific for cardiac ischemia. Recently, Turedi et al. [2] showed that the level of IMA may be of use in the diagnosis of pulmonary embolism, another ischemic condition. Incarceration is the state of an external hernia which cannot be reduced into the abdomen. Implying an increased risk of obstruction and strangulation, incarceration has great importance [3]. Incarcerated external hernias are the second most common cause of small intestinal obstructions [4]. Roughly 5% of all patients having an operation for external hernia are explored as an emergency. Strangulated external hernia is a relatively common and serious surgical emergency and accounts for most of the deaths from this condition [5]. Clinical validation of any test for ischemia is difficult as there is no accepted diagnostic gold standard. And the preoperative diagnosis or prediction of ischemia is important for surgeons because ischemia changes the operative strategy. Thus we planned this study and aimed to show relation between the intestinal ischemia and IMA. 1.1. Materials and Methods Our study was initiated after £¿anakkale Onsekiz Mart
%U http://www.hindawi.com/journals/dm/2013/185425/