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June 12, 1967

Enzymes in Intestinal Strangulation-Obstruction

Author Affiliations

Ogden, Utah

JAMA. 1967;200(11):1000-1001. doi:10.1001/jama.1967.03120240128037

To the Editor:—  Largely due to delay in diagnosis, the mortality in strangulation-obstruction of the intestine remains unduly high. A serum enzyme determination that would aid in the early diagnosis of intestinal strangulation would be most helpful. It has been suggested that the determination of serum glutamic oxaloacetic transaminase and alkaline phosphatase might be useful in this regard.1 This study was designed to investigate the levels of these two enzymes and leucine aminopeptidase in serum, peritoneal fluid, and intestinal fluid during the first 14 hours following strangulation of a loop of ileum in dogs.

Methods:—  With previously described methods,2-4 control levels of alkaline phosphatase, glutamic oxaloacetic transaminase, and leucine aminopeptidase were established in serum, peritoneal fluid, and intestinal fluid of 12 dogs. By means of an extraperitoneal snare technique,5 a strangulation-obstruction (arterial and venous) of a 15-cm loop of distal ileum was produced. Serum enzyme levels were