Changes in body fluid markers in intestinal ischemia.

New Zealand rabbits were assigned randomly to three groups: sham operation, intestinal simple obstruction, and strangulation obstruction. To relate possible changes in the body fluid content of biochemical markers to the strangulation process, subsequent samples of blood and peritoneal fluid, for the determination of levels of creatine kinase (CK), lactic acid (LA), xanthine oxidase (XO), and inorganic phosphate (IP), were obtained at 1-, 2-, 4-, and 6-hour intervals, and intestinal histological specimens were graded blindly. Significant increases in plasma LA (3.93 +/- 0.26 v 2.99 +/- 0.37; P < .05), peritoneal LA (5.03 +/- 1.14 V 3.33 +/- 0.86; P < .05), and CK (940 +/- 146 v 772 +/- 165, P < .05) occurred after 1 hour of ischemic injury. Except for serum CK, all parameters in the blood and peritoneal fluid in group 3 were markedly elevated within 4 hours. The serum CK remained almost unchanged throughout the 6-hour study period. The results suggest that plasma LA, peritoneal LA, and CK are sensitive indicators in the early diagnosis of bowel ischemia; the determination of both serum and peritoneal XO and IP was also helpful for early diagnosis; in contrast, serum CK was not a useful indicator. The value of any biochemical marker as an early diagnostic tool for intestinal ischemia depends not only on its quantity but also on its location and mechanism of release.