scholarly journals TO STUDY PROGNOSTIC FACTORS IN PERFORATION PERITONITIS AND EVALUATING THE OUTCOME OF PATIENTS WITH PERFORATION PERITONITIS USING MANNHEIM PERITONITIS INDEX

2020 ◽  
pp. 1-4
Author(s):  
S. Jackison Singh ◽  
Dhanabir Thangjam ◽  
T. Arun Kumar Singh ◽  
N. Somorjit Singh
Keyword(s):  
Prognostic Factors ◽  
Scoring System ◽  
Analytical Study ◽  
Emergency Operation ◽  
Exclusion Criteria ◽  
Mannheim Peritonitis Index ◽  
Surgical Interventions ◽  
Perforation Peritonitis ◽  
Operative Findings ◽  
Eventual Outcome

BACKGROUND: Perforation peritonitis constitutes one of the commonest surgical emergency operation encountered by surgeons all over world as well as in India.There is no single,easily available laboratory test that predicts severity or prognosis in patients with perforation peritonitis. The aim of this study is to study prognostic factors in perforation peritonitis and evaluating the outcome of patients with perforation peritonitis using Mannhein Peritonitis Index. MATERIALS AND METHOD:The study was a prospective analytical study done in the Department of General Surgery, JNIMS,Imphal from 1st September 2017 to 31st august 2019 comprising of 100 consecutive patients in which diagnosis of perforation peritonitis were established by operative findings or surgical interventions during management were included in the study as per the inclusion and exclusion criteria. RESULTS: Among the various prognostic factors of the scoring system, age >50 years, nature of peritoneal fluid exudates and presence of organ failure had a significant role in predicting the eventual outcome of the patients.Colonic origin of sepsis was associated with worse outcome probably due to presence of faecal exudates which is commonly associated with colonic origin of sepsis. MPI < 21 was associated wih complications in 25% of patients whereas complications increases as MPI score increases with 34.5% of patients having complication in MPI ranging from 21-29. CONCLUSION: MPI is disease specific, easy scoring system for predicting outcomes in patients with perforation peritonitis

EFFICACY OF MANNHEIM PERITONITIS INDEX IN PREDICTION OF MORTALITY AND MORBIDITY IN PATIENTS WITH SECONDARY PERITONITIS

2021 ◽  
pp. 66-68
Author(s):  
Mayank Mangwani ◽  
Subhash Chander Sharma ◽  
Alok Vardhan Mathur
Keyword(s):  
Organ Failure ◽  
Scoring System ◽  
Secondary Peritonitis ◽  
Hollow Viscus ◽  
Irreversible Damage ◽  
Mannheim Peritonitis Index ◽  
Generalized Peritonitis ◽  
Prediction Of Mortality ◽  
Perforation Peritonitis ◽  
Hollow Viscus Perforation

Background: Acute generalized peritonitis following hollow viscus perforation is a potentially life threatening condition leading to a cascade of infective processes, sepsis, disseminated intravascular coagulation, multi organ failure and death in the presence of irreversible damage to the vital organs. Grading the severity of acute peritonitis can contribute in better management of patients with perforation peritonitis. The Mannheim Peritonitis Index (MPI) scoring system takes into account various characteristics like age of the patient, gender, duration of peritonitis, organ failure, Malignancy, colonic sepsis, extent of spread and character of the peritoneal uid. The Objective of this study was to determine the Prognostic value of MPI in patients with Secondary Peritonitis. Methods: In this study conducted at SMI Hospital, Dehradun, Over a period of 1 year, all patients presenting with features of Peritonitis due to hollow viscus perforation were included. MPI score of all the patients were calculated and categorized into three groups; less than 21, 21-29 and more than 29. Mortality of patients from each group was calculated and predictive value of each factor was determined. Results:Total 150 patients were included in this study. There were total 21 mortalities. For patients with a score <21, the mortality rate was 0%; for score 21–29, it was 4.3%; and for score >27, it was 67.9% (P < 0.001). Age> 50 years, presence of organ failure, malignancy, presentation after 24 hours, generalized peritonitis and Fecal exudate were associated with higher mortality rates. Conclusions: MPI is a simple and useful scoring system to determine the prognosis and complications in patients with perforation peritonitis.

scholarly journals Effectiveness of Mannheim peritonitis index scoring system in predicting the morbidity and mortality in peritonitis due to hollow viscous perforation

2021 ◽  
Vol 8 (5) ◽  
pp. 1490
Author(s):  
Sachin Murukanahalli Basavaraju ◽  
Akshatha Hebbale Srinivas ◽  
Rakshitha Janardan
Keyword(s):  
Organ Failure ◽  
Scoring System ◽  
Morbidity And Mortality ◽  
Medical Sciences ◽  
Mannheim Peritonitis Index ◽  
Mortality And Morbidity ◽  
Post Operative Period ◽  
Operative Complications ◽  
Risk Patients ◽  
Perforation Peritonitis

Background: To study the spectrum and prognostic factor in perforation peritonitis. To evaluate the outcome of patients and identification of high risk patients using Mannheim peritonitis index.Methods: 80 patients with hollow viscous perforation admitted in the Dept. of Surgery Adhichuchanagiri Institute of Medical sciences from January 2019 to June 30 2020 were included in the study. Necessary data was collected; MPI score was calculated for each patient and analysis done.Results: The number of post-operative complications, hospital stay and mortality proportionately increased with the MPI score. In our study Age >50 years, Organ failure at admission pre operatively and MPI scoring found to be statistically significant. Out of the 8 variables used in this scoring system, age more than 50 years and organ failure on admission carried more significance in predicting the morbidity and mortality in the post operative period than the other variables.Conclusions: Mannheim peritonitis index is a simple and effective method in predicting the mortality and morbidity of patients with hollow viscous perforation.

scholarly journals Evaluation of Mannheim peritonitis index to predict outcome of patients with hollow viscus perforation

2020 ◽  
Vol 7 (5) ◽  
pp. 1385
Author(s):  
Jotdeep Singh Bamrah ◽  
Gopal Swaroop Bhargava ◽  
Manu Kohli
Keyword(s):  
Scoring System ◽  
P Value ◽  
Predictive Capacity ◽  
Chi Square ◽  
Hollow Viscus ◽  
Mannheim Peritonitis Index ◽  
Mortality And Morbidity ◽  
Generalized Peritonitis ◽  
Perforation Peritonitis ◽  
Hollow Viscus Perforation

Background: Acute generalized peritonitis from gastrointestinal hollow viscus perforation is a potentially life-threatening condition. Mannheim peritonitis index (MPI) is a specific scoring system that facilitates early identification of patients with severe peritonitis for aggressive surgical approach and improved outcomes.Methods: A prospective observational study in 60 patients attending surgical emergency unit with perforation peritonitis was conducted to analyse the predictive capacity of MPI. MPI score was categorized into 3 groups: <21, 21 to 29 and >29. Data was compared for predicting mortality and morbidity. P value, chi square test and 95% CI were used as statistical tools.Results: Two thirds of 60 patients studied were younger than 50 years of age. Prognosis was poorer in patients above 50 years with age. 80% presented after 24 hours. Ileal perforation was the commonest etiology. Morbidity and mortality were worst in patients with MPI score >29.Conclusions: Mannheim peritonitis index is disease specific, easy to apply and effective scoring system predicting the outcome in perforation peritonitis, with increasing MPI score being directly proportional to higher mortality and morbidity of the patient.

scholarly journals Spectrum of presentation and prognostic factors in non-traumatic small bowel perforations

2021 ◽  
Vol 8 (12) ◽  
pp. 3558
Author(s):  
Anoop Yadav ◽  
Satish Kumar ◽  
Sanjay Marwah ◽  
Narottam S. Argal ◽  
Chander M. Yadav ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Small Bowel ◽  
Bowel Perforation ◽  
Pulmonary Complications ◽  
Small Bowel Perforation ◽  
Duration Of Surgery ◽  
Purulent Peritonitis ◽  
Perforation Peritonitis ◽  
Operative Findings ◽  
The Impact

Background: The small bowel perforation peritonitis is one of the main causes of generalized acute peritonitis in developing countries.The aim is to find out the prognostic factors affecting the mortality and morbidity of non-traumatic small bowel perforations.Methods: A total of 50 patients of any age and either gender of non-traumatic small bowel perforation peritonitis were included and studied prospectively. The prognostic evaluation was assessed by the impact of pre-operative prognostic factors and per operative findings on post-operative complications and mortality.Results: One third of the patients were of 20-30 years of age followed by 18% who belonged to 10-20 years age group. Operative findings revealed mean duration of surgery was 2 hours. Majority of patients (33) had bilio-purulent peritonitis. Post-operative pulmonary complication revealed 56% (28 out of 50) patients were having pulmonary complications. Post-operative wound complication showed surgical site infection as the most common complication noted and managed by sending wound culture and changing antibiotics. Second most common was burst abdomen managed initially by dressing and thereafter secondary wound closure. Delay in intervention (DII) had significant correlation with world society of emergency surgery (WSES) score and amount of peritoneal fluid.Conclusions: Most common cause of non-traumatic small bowel perforation was typhoid ileal perforation with most common presentation being pain abdomen. The significant factors defining the outcome of these patients were volume of intra-peritoneal fluid (purulent/fecal) >1000 ml, WSES score >6 and Mannheim’s peritonitis index (MPI)>18.

scholarly journals Clinico-pathological and etiological evaluation of acute appendicitis and assessment of significance of laboratory and ultrasonography examination as an ancillary aid to clinical diagnosis

2019 ◽  
Vol 6 (6) ◽  
pp. 1954
Author(s):  
Sailendra Nath Paul ◽  
Dilip Kumar Das
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Scoring System ◽  
Clinical Symptoms ◽  
Lower Abdominal Pain ◽  
Complication Rates ◽  
Alvarado Score ◽  
Negative Appendicectomy ◽  
Operative Findings

Background: Timely diagnosis and intervention of acute appendicitis reduces morbidity and mortality associated with the disease condition. The study aimed to evaluate the etiology of acute appendicitis, to analyze the sensitivity of modified Alvarado scoring system and radiology in the diagnosis of acute appendicitis and to correlate the observations of laboratory tests, operative findings with the histopathological report of specimen of appendix.Methods: This was a prospective study done on 100 patients with clinical symptoms of acute right lower abdominal pain suggestive of appendicular origin during the period from February 2015 to January 2016 in the department of surgery thorough clinical assessment, laboratory investigations, ultrasound findings as were done for all patients. After confirming the diagnosis of AA the patients had operative intervention and specimens were sent for histopathological study.Results: Male preponderance was seen in the study. Majority of them belongs to 21 to 30 years age group (50%). Faecolith was the most common etiological factor observed (58%). Abdominal pain (100%) was the most common clinical symptom. Alvarado score had sensitivity of 95.74% and specificity of 66.67% in diagnosing AA. In correlation to histopathological findings, ultrasonography findings showed 100% positive visualization rate in all 71 cases. Elevated ESR (94%) had high diagnostic accuracy as confirmed by HPE finding (96.81%) which is statistically significant (p<0.000).Conclusions: Alvarado scoring system, elevated ESR levels and USG findings of the appendix can be considered as adjuncts to clinically diagnose the AA, to improve the diagnostic accuracy thereby consequently the rate of negative appendicectomy can be reduced and thus decreases the complication rates.

scholarly journals Comparison of pre-operative ultrasonography and magnetic resonance cholangiopancreatography with intra-operative surgical findings among patients suspicious to choledocholithiasis.

2020 ◽  
Author(s):  
Pulak Kumar Samanta ◽  
Sabyasachi Bakshi
Keyword(s):  
Magnetic Resonance Cholangiopancreatography ◽  
Stone Disease ◽  
Lower Yield ◽  
Exclusion Criteria ◽  
Cbd Stones ◽  
The Mean ◽  
Cbd Stone ◽  
Set Up ◽  
Operative Findings ◽  
Single Center Observational Study

Abstract BACKGROUND: Choledocholithiasis with cholelithiasis is a common problem in the middle and older age group people . Aim of this study is to assess the usefulness of ultrasonography in the diagnosis of choledocholithiasis in resource poor set up.METHODS: After matching the inclusion and exclusion criteria, all cases of diagnosed Choledocholithiasis were taken for this prospective, single center, observational study.RESULTS: Out of total 130 subjects, 41 were male and 89 were female. Increased incidence of choledocholithiasis was found in females (M: F= 1: 2.08). The mean age of presentation was 49.27 ± 10.60 years. Ultrasonography was able to diagnose CBD stones in 57patients (43.84%) and ductal dilatation in 89(68.46%). Whereas, MRCP detected CBD stones in 112 (86.15%).Cholelithiasis was associated with choledocholithiasis in 108 patients (83.07%). CONCLUSIONS: In the evaluation of choledocholithiasis, in our study particularly trans-abdominal USG seemed to have a lower yield than expected for accuracy in determining choledocholithiasis when compared to MRCP and Intra-operative findings. So a negative USG in a particular may not exclude choledocholithiasis. So,MRCP is the ‘investigation of choice’ among the suspicious patients for CBD stone disease. That is why prior to cholecystectomy in symptomatic patients with deranged LFT, MRCP always to be done, to detect the missed stone in CBD.

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