From:  Short bowel syndrome after near total enterectomy in an elderly patient: case report and review of the literature

 Perioperative laboratory findings and clinical interpretation.

ParametersPreoperative (04.02.2024)Early postoperative (06.02.2024)Postoperative day 2 (07.02.2024)Reference rangeClinical interpretation
WBC (× 103/µL)14.511.46.464.5–11Initial leukocytosis consistent with acute ischemia; normalization post-surgery.
Neutrophils (× 103/µL)11.0810.375.751.8–7.7Marked neutrophilia reflecting severe inflammatory response.
Lymphocytes (× 103/µL)2.490.620.401.2–3.9Progressive lymphopenia indicates systemic stress and poor prognosis.
NLR (ratio)4.4516.7314.38-Extremely elevated NLR associated with bowel necrosis and mortality.
CRP (mg/L)21.0335.5328.6< 5Severe systemic inflammation due to mesenteric ischemia and necrosis.
Hemoglobin (g/dL)11.011.39.511.7–16.1Postoperative anemia following major bowel resection.
Platelets (× 103/µL)218260188150–400Preserved platelet count.
Creatinine (mg/dL)0.831.472.450.5–0.9Progressive AKI postoperatively.
eGFR (mL/min)63.732.317.3≥ 90Worsening renal function consistent with multiorgan dysfunction.
AST (U/L)4332345–34Mild ischemic hepatocellular injury.
ALT (U/L)3227220–55Within normal limits.
LDH (U/L)626--125–220Markedly elevated, reflecting tissue ischemia and necrosis.
Amylase (U/L)155--28–100Elevated, likely secondary to intestinal ischemia.
INR-1.561.660.8–1.2Coagulopathy associated with ischemia and anticoagulation.
aPTT (sec)-45.138.422–30Prolonged due to anticoagulation and systemic inflammation.

Clinical note: Markedly elevated CRP and NLR values were consistent with extensive bowel necrosis and poor prognosis. AKI: acute kidney injury; ALT: alanine aminotransferase; aPTT: activated partial thromboplastin time; AST: aspartate aminotransferase; CRP: C-reactive protein; eGFR: estimated glomerular filtration rate; INR: international normalized ratio; LDH: lactate dehydrogenase; NLR: neutrophil-to-lymphocyte ratio; WBC: white blood cell.