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Year : 2022  |  Volume : 28  |  Issue : 1  |  Page : 32-36

Neutrophil–Leucocyte ratio as a predictor of bowel viability in incarcerated hernia: A cross-sectional study

Department of General Surgery, Government Medical College, Thiruvananthapuram, Kerala, India

Correspondence Address:
Dr. T K Deepak
Department of General Surgery, Government Medical College, Thiruvananthapuram - 695 011, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ksj.ksj_17_22

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Introduction: Incarcerated hernias can lead to bowel obstruction or strangulation, leading to loss of bowel viability. One of the changes occurring in our body during incarceration or strangulation of hernia is neutrophil leucocyte ratio (NLR) change. This relationship can be made use of for recognising hernia as, early or late leading to bowel ischaemia. It helps to decide safe non-operative management or early surgical intervention to prevent life-threatening complications. Primary objective of the study was to assess the predictive accuracy of preoperative neutrophil–leucocyte ratio and bowel viability amongst patients with incarcerated hernia. The secondary objective was to identify the relationship between preoperative neutrophil–lymphocyte ratio and bowel viability in incarcerated hernia. Methodology: This cross-sectional study which used diagnostic test evaluation was done with a sample size of 100 patients, after obtaining informed consent. Detailed history, physical examination and laboratory investigations were collected, and the need for bowel resection was assessed, surgery was carried out under aseptic precautions and checked for bowel viability and then comparison done with neutrophil–leucocyte ratio and data analysed using SPSS software (IBM-SPSS, New Delhi, India 2021) using Chi-square test. Results: The majority belonged to 51–60 years of age, 66 belonged to male gender and 31 patients underwent bowel resection. The mean neutrophil–leucocyte ratio was obtained as 0.84, and using the Chi-square test was found to be statistically significant in comparing relation between the ratio and bowel non-viability. The mean neutrophil–lymphocyte ratio was obtained as 11.1, and using the Chi-square test, there is a statistically significant relation between the ratio and bowel non-viability. Conclusion: Neutrophil–leucocyte ratio can be used as a predictive marker for early detection of non-viability of bowel. There is a statistically significant relation between the ratio and bowel non-viability.

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