Journal of Gastroenterology

, Volume 46, Issue 4, pp 492–500 | Cite as

Diagnosis of ischemic small bowel disease by measurement of serum intestinal fatty acid-binding protein in patients with acute abdomen: a multicenter, observer-blinded validation study

  • Tatsuo KandaEmail author
  • Akihiro Tsukahara
  • Kyo Ueki
  • Yasuo Sakai
  • Tatsuo Tani
  • Atsushi Nishimura
  • Toshiyuki Yamazaki
  • Yoichi Tamiya
  • Tetsuya Tada
  • Masaki Hirota
  • Jun Hasegawa
  • Hiroyuki Funaoka
  • Hiroshi Fujii
  • Katsuyoshi Hatakeyama
Original Article—Alimentary Tract



Intestinal fatty acid-binding protein (I-FABP) is a low-molecular-mass (15 kDa) cytosolic protein found exclusively in the epithelial cells of the small bowel mucosa. We aimed to evaluate the clinical usefulness of serum I-FABP measurement for the diagnosis of ischemic small bowel disease.


Patients with a clinical diagnosis of acute abdomen were recruited for this multicenter trial at one university hospital and nine city hospitals over a 13-month period. Serum I-FABP levels were measured in 361 eligible patients by an enzyme-linked immunosorbent assay using a specific monoclonal antibody.


Of the 361 patients, 242 underwent surgery, and small bowel ischemia was diagnosed in 52 patients. The mean serum I-FABP level in the patients with small bowel ischemia was 40.7 ± 117.9 ng/ml, which was significantly higher than that in patients with non-ischemic small bowel disease (5.8 ± 15.6 ng/ml) and those with non-small bowel disease (1.8 ± 1.7 ng/ml). The serum I-FABP cutoff level for the diagnosis of small bowel ischemia was 3.1 ng/ml. Serum I-FABP was more efficient than conventional biochemical markers, in terms of sensitivity and positive and negative predictive values, in the diagnosis of small bowel ischemia. However, its specificity was slightly lower than that of creatinine phosphokinase or lactate dehydrogenase. The positive and negative likelihood ratios of serum I-FABP were 3.01 and 0.29, respectively.


Serum I-FABP measurement is a non-invasive method that is potentially useful for the efficient identification of patients with acute abdomen who are at risk of small bowel ischemia.


Acute abdomen Biomarker ELISA I-FABP Intestinal ischemia 



We wish to thank Dr. K. Akazawa, Professor of the Division of Information Science and Biostatistics, Niigata University Graduate School of Medical and Dental Sciences, for helpful advice on statistical analysis.


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Copyright information

© Springer 2011

Authors and Affiliations

  • Tatsuo Kanda
    • 1
    Email author
  • Akihiro Tsukahara
    • 2
  • Kyo Ueki
    • 3
  • Yasuo Sakai
    • 4
  • Tatsuo Tani
    • 1
  • Atsushi Nishimura
    • 5
  • Toshiyuki Yamazaki
    • 6
  • Yoichi Tamiya
    • 7
  • Tetsuya Tada
    • 8
  • Masaki Hirota
    • 9
  • Jun Hasegawa
    • 10
  • Hiroyuki Funaoka
    • 11
  • Hiroshi Fujii
    • 12
  • Katsuyoshi Hatakeyama
    • 1
  1. 1.Division of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
  2. 2.Department of SurgeryNiigata Prefecture Shibata HospitalShibataJapan
  3. 3.Department of SurgeryKariwagun General HospitalKashiwazakiJapan
  4. 4.Department of SurgerySaiseikai Niigata Daini HospitalNiigataJapan
  5. 5.Department of SurgeryNagaoka Chuo General HospitalNagaokaJapan
  6. 6.Department of SurgeryNiigata City General HospitalNiigataJapan
  7. 7.Department of SurgeryNiigata Prefecture Yoshida HospitalTsubameJapan
  8. 8.Department of SurgeryTachikawa General HospitalNagaokaJapan
  9. 9.Department of SurgeryNiigata Prefecture Muikamachi HospitalMinamiuonumaJapan
  10. 10.Department of SurgeryJapanese Red Cross Nagaoka HospitalNagaokaJapan
  11. 11.DS Pharma Biomedical Co., Ltd.OsakaJapan
  12. 12.Department of Bioscience and BiotechnologyShinshu UniversityNaganoJapan

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