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The role of immature granulocyte in the early prediction of gastrointestinal tract perforations

Background/Aim: Gastrointestinal system (GIS) perforations cause acute abdomen an indication for emergency intervention. Early detection is very important in gastrointestinal perforations to prevent mortality and morbidity. This study aimed to examine whether immature granulocyte (IG) and IG percentages (IG%) can be used as a simple and easy marker for identifying gastrointestinal system perforations early on. 
Methods: Between January 1, 2020, and January 1, 2022, 120 patients who presented to Hitit University Erol Olçok Training and Research Hospital's emergency service and underwent surgery on by the General Surgery Clinic with the diagnosis of the acute abdomen were investigated. The patients were divided into two groups. Patients in group 1 included those with peptic ulcers and bowel perforations. Group 2 was considered the control group. Of the 36 patients in group 2, 22 had acute appendicitis, 12 had ileus-related bridectomy or bowel resection, and two had acute cholecystitis. The common patient feature in this group was full-thickness or serosal iatrogenic bowel injury and repair. Pre-operative IG and IG% values were obtained from routine complete blood count values. IG and IG% values were compared between groups 1 and 2, and the predictive value of these biomarkers in the early diagnosis of GIS perforations was investigated. 
Results: The mean age of the patients was 55.49 (19.58). The study consisted of 45 (37.5%) female patients and 75 (62.5%) male patients. Group 1 had 84 patients, whereas Group 2 had 36. When the two groups were evaluated, the IG value was higher in Group 1 (P < 0.001). In terms of the percentage value of immature granulocytes, a statistically significant difference was found between Groups 1 and 2 (P = 0.001). As a result, Group 1's IG and IG% values were much greater than those in Group 2. 
Conclusion: IG and IG% values are inflammatory parameters that can be easily studied in routine hematology tests. According to this study, IG and IG% values were found to be higher in gastrointestinal tract perforations based on result blood tests taken at the time of admission to the emergency department.