Prognostic Scoring Indicator in Evaluation of Clinical Outcome In Intestinal Perforations

Ahuja, Ashish; Pal, Ravinder

doi:10.7860/jcdr/2013/6572.3375

Cited by 18 publications

(20 citation statements)

References 8 publications

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“…Based on these factors, several scoring systems have been used to evaluate the condition of the patient with duodenal ulcer perforation, such as the Boey score [11], Mannheim Peritonitis Index [12–14], APACHE II score [15] and Jabalpur score [16]. In particular, the perforation-operation interval seems to represent an important factor for mortality.…”

Section: Discussionmentioning

confidence: 99%

Giant duodenal ulcers after neurosurgery for brainstem tumors that required reoperation for gastric disconnection: a report of two cases

et al. 2016

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BackgroundDespite the efficacy of pharmacotherapy for gastrointestinal ulcers, severe cases of bleeding or perforation due to gastrointestinal ulcers still occur. Giant duodenal ulcer perforation is an uncommon but difficult-to-manage pathology with a high mortality rate. We report two cases of giant duodenal ulcer perforation after neurosurgery for brainstem tumors that needed reoperation for gastric disconnection because of postoperative leakage and bleeding.Case presentationBoth cases had undergone neurosurgery for brainstem tumors, and the patients were in a shock state for several days with peritonitis due to giant duodenal perforation. In Case 1, antrectomy with Billroth II reconstruction was performed. However, reoperation for gastric disconnection was needed because of major leakage of gastrojejunostomy and jejunojejunostomy. In Case 2, an omental patch, cholecystectomy, and insertion of a bile drainage tube from the cystic duct were performed for the giant duodenal ulcer, but leakage and bleeding from the ulcer edge required reoperation for gastric disconnection.ConclusionsBrainstem tumors in these cases might have been related to duodenal ulcer perforation with late diagnosis that progressed to severe sepsis. For giant duodenal ulcer perforation with poor general condition, simple closure including omental patch or antrectomy with reconstruction is hazardous. Antrectomy with gastric disconnection, meaning gastrostomy, duodenostomy, feeding jejunostomy and cholecystectomy, is recommended.

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Section: Discussionmentioning

confidence: 99%

Giant duodenal ulcers after neurosurgery for brainstem tumors that required reoperation for gastric disconnection: a report of two cases

et al. 2016

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“…It is often associated with significant morbidity and mortality. 4,5 Grading the severity of acute peritonitis has assisted in decision making and has improved therapy in the management of severely ill patients. 6 The risk assessment by important clinical parameter has been extremely useful in evaluating new therapies, in monitoring resources utilization and improving the quality of care.…”

Section: Introductionmentioning

confidence: 99%

Apache II score in predicting surgical outcome in patients of secondary peritonitis: a prospective and observational study

et al. 2020

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Background: Peritonitis is defined as inflammation of the serosal membrane that lines the abdominal cavity and the organs contained therein. Secondary peritonitis presenting as acute generalized peritonitis is a common surgical emergency often associated with significant morbidity and mortality. Many scoring systems have been found useful in predicting the outcome in critically ill patients, thus allowing application of resources for effective use. Amongst them acute physiology and chronic health evaluation score (APACHE II), have a strong relationship to the outcome than previous groupings without consideration for systemic effect of the intra-abdominal sepsis. Methods: This study was conducted in the Department of General surgery, Sri Maharaja Hari Singh (SMHS) Hospital an associated hospital with the Government Medical College Srinagar, J&K, India. The prospective study was conducted over a period from October 2016 to September 2018 (Two Year) on 108 patients diagnosed with secondary peritonitis. Data was collected and analysed using SPSS v 20. Results: study included 108 patients with males involving 74.1% (80). The mean age of our study was 34 yr. (2-88 yr.), and 21-40 yr. (44.5%) group was mostly involved. Pain abdomen was present in 100% patients followed by nausea/vomiting (88%). Higher the APACHE VII score higher were post-operative complications (31+ score group 100%), mortality (31+ score group 100%) and less hospital stay (31+ score group 1.5 days) due to increased mortality. Conclusions: APACHE II score correlated well with postoperative complications, outcome, hospital stay. However, in patients with very high Apache score more than 30, the mean duration of hospital stay is less due to associated increased mortality during early Hospital stay.

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“…It is often associated with significant morbidity and mortality. 1 The prognosis and outcome of peritonitis depend upon the interaction of many factors, including patient-related factors, disease-specific factors, and diagnostic and therapeutic interventions. Categorizing patients into different risk groups would help prognosticate the outcome, select patients for intensive care and determine operative risk, thereby helping to choose the nature of the operative procedure, e.g.…”

Section: Introductionmentioning

confidence: 99%

A prospective study of Mannheim peritonitis index as a prognostic scale in analysis of outcome in hollow viscus perforation

Ramesh

Ramesh²

2018

Int Surg J

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Background: MPI as a prognostic index helps in analysis of prognosis in peritonitis in hollow viscus perforation. The factors that are considered in MPI index are routinely used in assessment of surgical patients, they are easily available, routinely performed, and helps in arrival at a prognosis in fast and effective way.Methods: A prospective survey of patients with acute generalized peritonitis due to hollow viscus perforation was carried out in general surgical wards of our institute during the period starting from January 2014 to December 2015. Study population consisted of 150 consecutive patients with performative peritonitis, which confirmed on emergency laparotomy.Results: The Mannheim peritonitis index emerged as a reliable marker for assessing the severity and prognosis of intra-abdominal infection with sensitivity and specificity comparable to APACHE II score which has been adopted as the gold standard by Surgical Infection Society. The score designed specifically for peritonitis, combines preoperative and operative data and is easy to apply. MPI scores were consistent with low scores among survivors and higher scores among non-survivors.Conclusions: MPI scores in the analysis were sharp predictor of mortality.

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Prognostic Scoring Indicator in Evaluation of Clinical Outcome In Intestinal Perforations

Cited by 18 publications

References 8 publications

Giant duodenal ulcers after neurosurgery for brainstem tumors that required reoperation for gastric disconnection: a report of two cases

Giant duodenal ulcers after neurosurgery for brainstem tumors that required reoperation for gastric disconnection: a report of two cases

Apache II score in predicting surgical outcome in patients of secondary peritonitis: a prospective and observational study

A prospective study of Mannheim peritonitis index as a prognostic scale in analysis of outcome in hollow viscus perforation

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