Aim: We designed this study to determine whether the fibrinolytic marker D-dimer is a useful early marker of acute 
mesenteric ischemia. 
Methods: We measured plasma D-dimer levels in 25 patients presenting with severe abdominal pain, in addition to 10 
healthy controls. Based on laparotomy findings, patients were categorized into those with acute mesenteric ischaemia 
(AMI)(15 patients) and those without acute mesenteric ischaemia (NAMI) (10 patients). 
Results: We demonstrated significant increase of plasma D-dimer level in AMI group compared to NAMI group (P < 0.01). Furthermore, plasma D-dimer level was significantly elevated in NAMI group compared to controls (P < 0.001). 
Conclusion: Plasma D-dimer > 3.8 ug/ml combined with relevant clinical variables has a high positive predictive value for early identification of patients with AMI. However, plasma D-dimer < 0.53 ug/ml has a high negative predictive value for 
AMI and could be used as an exclusion test. This strategy could aid in the decision for urgent surgery with subsequent 
improvement of the surgical outcome.