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Prognostic Factors for Generalized Peritonitis Secondary to Colonic Perforation
Journal of the Korean Society of Coloproctology ; : 216-220, 2003.
Artigo em Coreano | WPRIM | ID: wpr-82050
ABSTRACT

PURPOSE:

The prognosis following colonic perforation is generally regarded as worse than it is for upper gastrointestinal perforation. Moreover, the increasing incidence of colon cancer associated perforation is another reason for the present study of colonic perforation in the present study. We reviewed and analyzed various types of colonic perforations to determine which prognostic factors were still useful for the treatment of colonic perforation.

METHODS:

Thirty six patients (mean age, 51.5; 24 males) with generalized peritonitis secondary to a colonic perforation were studied retrospectively. All the patients had undergone an exploratory laparotomy. The severity of the clinical condition was recorded according to the APACHE III scoring system for all the patients when they were first seen. Mortality and morbidity were analyzed for possible prognostic factors, such as age, type of operation, association with malignancy, and APACHE-III score.

RESULTS:

Penetrating trauma was the leading cause of perforation (27.8%), and iatrogenic perforations accounted for 19.4% of the total. Among nontraumatic perforations, malignancy was the major pathology (25.0%). The sigmoid colon was the most frequent site of perforation. Types of surgical treatment varied according to the general conditions of the patients. In 22 patients, the operation was finished with primary closure alone. A colonic resection was performed in 14 patients, and a proximal diversion was performed in 19 patients (after either a resection or primary closure). Analysis of the various clinical variables showed that old age (>60), underlying malignancy, and the APACHE III score were significant prognostic factors for the surgical outcome.

CONCLUSIONS:

These results suggest that penetrating injuries are still the main cause of colonic perforation and that iatrogenic and malignancy-related perforations are increasing. Among other variables, old age, underlying malignancy and the APACHE III score are significant prognostic factors for the surgical outcome.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Patologia / Peritonite / Prognóstico / Colo Sigmoide / Incidência / Estudos Retrospectivos / Mortalidade / Colo / Neoplasias do Colo / APACHE Tipo de estudo: Estudo de incidência / Estudo observacional / Estudo prognóstico Limite: Humanos Idioma: Coreano Revista: Journal of the Korean Society of Coloproctology Ano de publicação: 2003 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Patologia / Peritonite / Prognóstico / Colo Sigmoide / Incidência / Estudos Retrospectivos / Mortalidade / Colo / Neoplasias do Colo / APACHE Tipo de estudo: Estudo de incidência / Estudo observacional / Estudo prognóstico Limite: Humanos Idioma: Coreano Revista: Journal of the Korean Society of Coloproctology Ano de publicação: 2003 Tipo de documento: Artigo