ABSTRACT
THE AIM OF THE STUDY: was to answer the question whether or not determination of C-reactive protein in patients after serious abdominal surgeries can be prognostic of septic complications. MATERIAL AND METHODS: 36 patients who underwent elective surgeries were included in the study. The patients were included either in the group where no postoperative SIRS developed or in the group where postoperative SIRS did occur. In the seven-day period after the surgery, in 26 patients SIRS was found, and in 10 - sepsis was suspected (according to the ACCP/SCCM definitions). In patients who underwent abdominal surgeries blood concentration of C-reactive protein was determined prior to the surgery (measurement '0'), and then on postoperative days 1, 2, 3, 5 and 7. RESULTS: The test for two variables (C-reactive protein on postoperative days five and seven) showed statistically significant difference, and for one variable (C-reactive protein on day three) - difference at the limit of significance. Thus, it was found that in the postoperative SIRS group the level of C-reactive protein is higher than in the non-SIRS group. CONCLUSIONS: Serial measurements of C-reactive protein are useful in the first week after surgery, as they can be prognostic of postoperative septic complications. Such complications can be anticipated if CRP on postoperative day 5 is higher than 1/2 of the maximum CRP concentration on day 2 or day 3, or CRP > 150 mg/L as of postoperative day 3. Unfortunately, the severity of the disease cannot be projected based on C-reactive protein level.
Subject(s)
Postoperative Complications/blood , Postoperative Complications/diagnosis , Sepsis/blood , Sepsis/diagnosis , Abdominal Abscess/complications , Abdominal Abscess/diagnosis , Adult , Aged , Biomarkers/blood , Digestive System Neoplasms/surgery , Elective Surgical Procedures/adverse effects , Female , Humans , Male , Middle Aged , Postoperative Complications/etiology , Prognosis , Reoperation , Sepsis/etiology , Statistics, NonparametricABSTRACT
The article reports a rare case of hemobilia caused by ruptured hepatic artery aneurysm. Based on clinical symptoms, USG and ERCP common bile duct stones have been diagnosed primary. Because of no response to initial treatment (ERCP) and appearing a new clinical symptom - bleeding in the upper gastrointestinal tract, another tests have been applied which results let us estabilish final diagnosis. The diagnostic problems of the hemobilia are discussed.
