Acute generalized peritonitis in adult African patients: Assessment of severity using APACHE II score

Adesunkanmi, A. R. K.; Badmus, Tajudeen A.; Agbakwuru, E A; Ogunronbi, Akinwumi B.

doi:10.1046/j.1442-2034.2003.00151.x

Cited by 18 publications

(21 citation statements)

References 31 publications

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“…In this series, children younger than 10 years and young adults between the ages of 11 and 20 years accounted for over half of the cases. This finding is similar to that reported by Badoe 6 in Ghana, Adesunkanmi et al 7 . in Nigeria and studies from India 8 and Pakistan, 9 where the majority of the patients were below 40 years of age, but differs from studies from the West, where elderly and middle‐aged patients with gastroduodenal perforations and inflammatory conditions of the colon constitute a significant number of cases of perforation peritonitis 10 .…”

Section: Discussionsupporting

confidence: 90%

Causes and treatment outcome of perforation peritonitis in north eastern Nigeria

Ali¹,

Gali

2010

Surgical Practice

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Background:Intestinal perforations cause generalized peritonitis and overwhelming sepsis resulting in high morbidity and mortality. The purpose of the present study was to review the causes and treatment outcome of non-traumatic perforation peritonitis in a government referral hospital in north-eastern Nigeria. Patients and Methods: In a retrospective study, the clinical records of 153 patients with intraoperative diagnosis of non-traumatic perforation associated peritonitis managed in the Federal Medical Centre, Azare, Nigeria between June 2004 and May 2009 were reviewed. Results: One hundred and fifty-three patients, comprising 112 males (73.2%) and 41 females were operated for perforation peritonitis, including 31 (20.3%) children. The mean age was 21.88 years Ϯ 14.51 (range 4-70). The mean time lapse between onset of symptoms and presentation to hospital was 5.4 Ϯ 3.7 days (range 0.75-21). Forty-eight (31.4%) of the patients were operated within 24 h of presentation and 105 (68.3%) after 24 h. The main symptoms were abdominal pain in 150 (98.9%), fever in 108 (70.6%), and abdominal distention in 108 (70.6%). The main causes of perforation peritonitis were typhoid ileal perforation in 98 (64.0%), perforated peptic ulcer in 25 (16.3%) and perforated appendix in 22. Tuberculous ileal perforation was seen in one (0.6%) patient. Wound infection 39 (25.5%) and wound dehiscence 15 (9.8%), were the most common postoperative complications. Enterocutaneous fistula was seen in 21 (13.7%) of the patients and was associated with mortality in nine (42.8%) patients. The overall mortality rate was 26.1%, mainly from overwhelming sepsis and severe electrolyte derangement. Conclusion: The outcome of perforation peritonitis depended on the underlying cause, the duration of symptoms before treatment, and the general health of the patient. Typhoid ileal perforation is the most common cause of perforation peritonitis in our environment.

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Section: Discussionsupporting

confidence: 90%

Causes and treatment outcome of perforation peritonitis in north eastern Nigeria

Ali¹,

Gali

2010

Surgical Practice

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“…Various studies reported that peritonitis is more common in 2 nd and 3 rd decade of life due to increased incidence of acid peptic disease and its complication in this age group. [6,7,8] Male preponderance is comparable to many other studies as smoking, alcoholism, stress and dietary factors more prevalent in male sex. [9,10] Most common cause of surgical peritonitis was gastro duodenal perforation which is usually found in 1 st part of duodenum and around pylorus of stomach which is comparable with other studies.…”

Section: Observationsupporting

confidence: 60%

Bacteriological Profile of Surgical Peritonitis: A Prospective Observational Study

Singh¹,

Singh²,

Agrawal³

et al. 2015

jemds

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Peritonitis is defined as inflammation of peritoneum that lines the abdominal cavity and the organs contained therein. In Surgical practice we most often encounter cases of peritonitis which are mostly secondary to hollow viscous perforation. Purpose of our study is to find out which type of peritonitis is more common in our institute, which is the most common bacteria isolated from peritoneal fluid and which antibiotic is it most sensitive to. We studied 104 cases of age group 16 and above of both sex who presented with clinical features of peritonitis. Peritoneal fluid was obtained and sent for culture and sensitivity. Peritoneal fluid culture was positive in 55.76% cases. The incidence of culture positivity increased with duration of presentation. Gastro duodenal perforation was the most common etiological factor for peritonitis found in 42.86% cases followed by ileal perforation. E. coli was the most common bacteria isolated in study group followed by klebsiella. Most of the cultures were monomicrbial. E. coli was sensitive to amikacin, imipenem and meropenem (100%). So in our study Gram negative infection is more common in surgical peritonitis. Identification of bacteria and its sensitivity to the antibiotics is helpful to avoid injudicious use of antibiotics in surgical peritonitis. Proper choice of antibiotics along with surgical management and proper resuscitation in cases of surgical peritonitis can reduces mortality and morbidity associated with these high risk cases.

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“…16,17 Although such a system for the evaluation of EVD would require validation before it could be used, it may be possible to develop a system similar to APACHE to predict the risk of death with the use of clinical data that are available on presentation. Other measures that were found to differ significantly between patients with fatal EVD and those with nonfatal EVD are shown in Table S11 in the Supplementary Appendix.…”

Section: Resultsmentioning

confidence: 99%

Clinical Illness and Outcomes in Patients with Ebola in Sierra Leone

Schieffelin

Shaffer

Goba³

et al. 2014

N Engl J Med

481

435

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BACKGROUND Limited clinical and laboratory data are available on patients with Ebola virus disease (EVD). The Kenema Government Hospital in Sierra Leone, which had an existing infrastructure for research regarding viral hemorrhagic fever, has received and cared for patients with EVD since the beginning of the outbreak in Sierra Leone in May 2014. METHODS We reviewed available epidemiologic, clinical, and laboratory records of patients in whom EVD was diagnosed between May 25 and June 18, 2014. We used quantitative reverse-transcriptase–polymerase-chain-reaction assays to assess the load of Ebola virus (EBOV, Zaire species) in a subgroup of patients. RESULTS Of 106 patients in whom EVD was diagnosed, 87 had a known outcome, and 44 had detailed clinical information available. The incubation period was estimated to be 6 to 12 days, and the case fatality rate was 74%. Common findings at presentation included fever (in 89% of the patients), headache (in 80%), weakness (in 66%), dizziness (in 60%), diarrhea (in 51%), abdominal pain (in 40%), and vomiting (in 34%). Clinical and laboratory factors at presentation that were associated with a fatal outcome included fever, weakness, dizziness, diarrhea, and elevated levels of blood urea nitrogen, aspartate aminotransferase, and creatinine. Exploratory analyses indicated that patients under the age of 21 years had a lower case fatality rate than those over the age of 45 years (57% vs. 94%, P = 0.03), and patients presenting with fewer than 100,000 EBOV copies per milliliter had a lower case fatality rate than those with 10 million EBOV copies per milliliter or more (33% vs. 94%, P = 0.003). Bleeding occurred in only 1 patient. CONCLUSIONS The incubation period and case fatality rate among patients with EVD in Sierra Leone are similar to those observed elsewhere in the 2014 outbreak and in previous outbreaks. Although bleeding was an infrequent finding, diarrhea and other gastrointestinal manifestations were common. (Funded by the National Institutes of Health and others.)

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Acute generalized peritonitis in adult African patients: Assessment of severity using APACHE II score

Cited by 18 publications

References 31 publications

Causes and treatment outcome of perforation peritonitis in north eastern Nigeria

Causes and treatment outcome of perforation peritonitis in north eastern Nigeria

Bacteriological Profile of Surgical Peritonitis: A Prospective Observational Study

Clinical Illness and Outcomes in Patients with Ebola in Sierra Leone

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