Elevated homocysteine levels predict small bowel necrosis.

Findings indicate that serum homocysteine levels serve as reliable predictors of irreversible transmural intestinal necrosis in patients with adhesive small bowel obstruction. Among 221 patients studied, those requiring surgical intervention exhibited markedly higher homocysteine, endotoxin, IL-5, IL-6, hs-CRP, IL-1β, and PCT levels. Notably, homocysteine demonstrated a sensitivity of 89.71% and specificity of 83.03%, outpacing other examined biomarkers. A cutoff level of 15.53 µmol/L was established for diagnosing small bowel necrosis.