Kinetics of Procalcitonin in the Management of Small Bowel Obstruction: A Preliminary Report

Background: Small Bowel Obstruction (SBO) is mainly due to adhesions acquired after abdominal surgery.Its management could be conservative or surgical but the choice is difficult because of the absence of clinico-biological markers.Serum procalcitonin (PCT) has previously been proposed as a biomarker.The aim was to present the kinetics' profiles of serum PCT in cases of Conservative Management (CM) success and surgical management (SM) in patients with SBO.Study design: From January to October 2013, 59 patients with adhesion-related SBO were included in a prospective, monocenter, non-randomized, clinical study.PCT was measured during 3 days maximum (or until the transit was restored), every six hours.The patients were divided into subgroups (conservative (CM) and surgical management (SM)).The predictive time points were identified with ROC curves.Results; Patients in CM group (n=47) presented at admission a lower PCT and a higher chloride than in the SM group (n=12) (p<0.003).The time points of PCT for predicting SM are at admission (threshold>0.165ng/mL; sensitivity (Se)=83.3% and negative predictive value (NPV)=93%), 18 hours after admission (threshold >0.275 ng/mL; Se=100% and NPV=100%) and 24 hours after admission (threshold>0.255ng/mL; Se=83.3% and NPV=95%). Conclusion:PCT is helpful in SBO's management.The more predictive time points are at admission, 18 hours and 24 hours after admission to identify the patients requiring surgery.