A note on Serum procalcitonin (PCT) level and Small Bowel Obstruction (SBO)
PCT has an interesting value in SBO management. A PCT value of 0.17 ng/mL has shown to be an 85% negative predictive value for failure of nonoperative management! And similarly, a PCT value of more than or equal to 0.57 ng/mL has an 83% of positive predictive value.
Famous ABOD (Acute Bowel Obstruction Diagnosis) study 1, showed that PCT value correlates well with medically managed group, patients who require surgery and patients who are found to have ischemia during surgery.
What is of more interesting in ABOD study, lactic acid and leucocytosis were not predictive of ischemia!!
1. Cosse C, Regimbeau JM, Fuks D, et al. Serum procalcitonin for predicting the failure of conservative management and the need for bowel resection in patients with small bowel obstruction. J Am Coll Surg 2013; 216:997.
2. Markogiannakis H, Memos N, Messaris E, et al. Predictive value of procalcitonin for bowel ischemia and necrosis in bowel obstruction. Surgery 2011; 149:394.