scholarly journals EFFECTIVENESS OF MANNHEIM PERITONITIS INDEX IN PREDICTING THE MORBIDITY AND MORTALITY OF PATIENTS WITH PERITONITIS FOLLOWING HOLLOW VISCUS PERFORATION

2020 ◽  
pp. 48-50
Author(s):  
Pradipta Pandit ◽  
Tanmoy Bhuyan ◽  
Rahul Kushwaha
Keyword(s):  
Surgical Treatment ◽  
Antimicrobial Agents ◽  
Risk Groups ◽  
Morbidity And Mortality ◽  
Related Factors ◽  
Hollow Viscus ◽  
Mannheim Peritonitis Index ◽  
Medical College ◽  
Specific Factors ◽  
Hollow Viscus Perforation

Background: One of the common cause of emergency surgery in India is peritonitis due to hollow viscous perforation. The morbidity and mortality of secondary peritonitis remains high despite advances in surgical skills, antimicrobial agents and supportive care. Many factors determine the prognosis and outcome which includes patient related factors, disease specific factors and management of the case. Management of these case are done by categorizing patients into different risk groups. Based on measuring simple clinical parameters in case of hollow viscous perforation Mannheim peritonitis index (MPI) is calculated. To know efficacy of MPI for predicting morbidity and mortality in hollow viscous perforation this study was conducted. Methods: 50 patients who were undergoing surgical treatment for peritonitis following hollow viscous perforation at Silchar Medical College and Hospital, Silchar were included in study. Clinical data, surgical treatment, outcome were documented and analysed. Results: In patients with MPI more than 29 the morbidity and mortality rate were higher. The most common complication in patients with MPI less than 21 was surgical site infection while of those with MPI more than 21 the respiratory complications were common. The ICU stay of the patients were increased if the MPI Score was higher. Conclusions: MPI is simple and effective in predicting morbidity and mortality in patients with hollow viscous perforation and is very easy to calculate.

scholarly journals Effectiveness of Mannheim peritonitis index in predicting the morbidity and mortality of patients with hollow viscous perforation

2017 ◽  
Vol 5 (2) ◽  
pp. 533
Author(s):  
Vivek A. Patil ◽  
Bibekananda Mahapatra ◽  
Anuradha Panchal ◽  
Sandesh Deolekar
Keyword(s):  
Surgical Treatment ◽  
Antimicrobial Agents ◽  
Surgical Site Infections ◽  
Risk Groups ◽  
Morbidity And Mortality ◽  
Respiratory Complications ◽  
Related Factors ◽  
Mannheim Peritonitis Index ◽  
Medical College ◽  
Specific Factors

Background: Peritonitis due to hollow viscous perforation is common cause of emergency surgery in India. Despite advances in surgical skills, antimicrobial agents and supportive care the morbidity and mortality of secondary peritonitis remains high. Prognosis and outcome of it depends on many factors which includes patient related factors, disease specific factors and management. Categorizing patients into different risk groups would help in management. Mannheim peritonitis index (MPI) is based on measuring simple clinical parameters in case of hollow viscous perforation. This study was conducted to know efficacy of MPI for predicting morbidity and mortality in hollow viscous perforation.Methods: 50 patients with peritonitis undergoing surgical treatment at Dr. D.Y. Patil medical college, Nerul were included in study. Demographic, clinical data, surgical treatment, outcome were documented and analysed.Results: The morbidity and mortality rate were higher in patients with MPI >29. Surgical site infections were most common complication in patients with MPI <21. Respiratory complications were common in patients with MPI >21. More ICU stay was required in in patients with MPI <21.Conclusions: MPI which is very easy to calculate is simple and effective in predicting morbidity and mortality in patients with hollow viscous perforation.

scholarly journals Surgical management and perioperative complications of peritonitis secondary to hollow viscus perforation in a tertiary care centre

2021 ◽  
Vol 8 (11) ◽  
pp. 3359
Author(s):  
Lokesh M. G. ◽  
S. Chandrashekar ◽  
Arundathi Raikar ◽  
Abhishek S. S.
Keyword(s):  
Perioperative Complications ◽  
Tertiary Care ◽  
Surgical Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Hollow Viscus ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Threatening Condition ◽  
Hollow Viscus Perforation

Background: High mortality and morbidity is associated with peritonitis secondary to hollow viscus perforation, proving it a most common life threatening condition which needs emergency surgical care. Hence a proper evaluation was needed regarding appropriate management to have a better outcome, which was a challenge to operating surgeon.Methods: A serial study of 96 cases of peritonitis secondary to hollow viscus perforation was conducted at tertiary care centre, department of general surgery, Mysore medical college and research institute, Mysore, Karnataka from the period of August 2020 to July 2021. Data related to aetiology, surgical intervention and its peri-operative complications were noted. Appropriate statistical analyses were done to draw the inference.Results: Out of 96 cases studied, 74 were male, 22 were female with mean age of 45.53 years. Most common cause of peritonitis was GU perforation, followed by idiopathic, infective, malignancy, appendicular perforation and Trauma.Conclusions: Hollow viscus perforation being most common surgical emergencies, surgical outcomes and its related complications depends on age, general condition, site, co-morbidities and aetiologies.

scholarly journals A comprehensive study on acute non-traumatic abdominal emergencies

2017 ◽  
Vol 4 (7) ◽  
pp. 2297
Author(s):  
Ajay Malviya ◽  
Ashfaque Hussain ◽  
Hitesh P. Bulchandani ◽  
Girish Bhardwaj ◽  
Subhash Kataria
Keyword(s):  
Acute Appendicitis ◽  
Age Groups ◽  
Diagnostic Procedures ◽  
Operative Management ◽  
Hollow Viscus ◽  
Correct Treatment ◽  
Medical College ◽  
Abdominal Emergencies ◽  
Hollow Viscus Perforation ◽  
Overall Mortality

Background: Abdominal pain is one of the most common reasons for visit to the emergency room. Acute appendicitis is the commonest cause. An accurate diagnosis is essential for the correct treatment, which in many cases will prevent the death of the patient. Mainstay of diagnosis is history and physical examination. If this information is inadequate to establish a diagnosis and urgent or immediate operation is unnecessary, the periodic re-examination helps document the progression of the disease and often avoids unnecessary surgical intervention. Today the combination of improved diagnostic procedures, antibiotic and better anaesthesia and preoperative and postoperative patient care has led to a decrease in morbidity and mortality of patients with acute abdomen. The objective of this study was to determine the various causes of non-traumatic acute abdominal emergencies, their incidence, management and mortality in both sexes and all age groups >12 years age.Methods: The Study was conducted on 1353 patients of non-traumatic abdominal emergencies admitted in the department of surgery, associated group of hospitals attached to Dr. Sampurnanand Medical College, Jodhpur over a period of 1 year extending from 1st January 2015 to 31st December 2015.Results: Most common cause of acute non-traumatic emergency in our study is acute appendicitis 61.71% of the patients. Out of 1353 cases of non-traumatic acute abdominal emergencies, 217 (16%) were managed conservatively while 1136 (84%) were operated. 96.64% cases of acute appendicitis were operated and only 3.36% underwent conservative management. The rate of operative intervention in acute intestinal obstruction and acute cholecystitis was 89.09% and 85.71% respectively. 81.89% cases of hollow viscus perforation were operated while 18.11% were treated conservatively. Only 18.18% cases of liver abscess underwent operation while all patients of Meckel's Diverculititis were managed operatively. All patients of acute pancreatitis were managed conservatively. Overall mortality in our study of acute non-traumatic abdominal emergencies was 3.39%.Conclusions: It can be concluded that acute non-abdominal emergencies admitted in the hospital constitute a major chunk of surgical patients, majority requiring operative management with limited mortality.

scholarly journals Study to determine etiological factors and surgical outcome of non traumatic abdominal hollow viscus perforation

2020 ◽  
Vol 7 (12) ◽  
pp. 4132
Author(s):  
Akshay S. Marathe ◽  
Varsha N. Bijwe
Keyword(s):  
Late Presentation ◽  
Sudden Onset ◽  
Morbidity And Mortality ◽  
General Surgeon ◽  
Peptic Ulcer Perforation ◽  
Hollow Viscus ◽  
Early Presentation ◽  
Etiological Factors ◽  
Chief Complaints ◽  
Hollow Viscus Perforation

Background: Hollow viscus perforation leading to peritonitis is a common emergency faced by a general surgeon. Late presentation, missed diagnosis and late interventions are frequent causes of morbidity and mortality. Thus in an interest to find out etiological factors, to assess the common type of perforations with their clinical presentation, surgical out come and finally prognosis and complications; forms the basis of present study.Methods: We carried out prospective study on total of 60 patients presenting with sudden onset pain in abdomen with guarding and rigidity per abdominally for etiology, surgical management and post- operative complications. Study was conducted between 1 January 2018 to 31 December 2018 (12 months), with follow up period up to 30 June 2019 (6 months).Results: Most common age group involved is 20-39 years (51.6%). Peptic ulcer perforation is the most common cause of hollow viscus perforation (46.4%). Abdominal pain and vomiting were the most common chief complaints and tenderness with guarding rigidity being the most commonly observed sign. Gas under diaphragm on X-ray standing abdomen is suggestive of hollow viscus perforation (41 out of 60 cases) but, it is not obligatory. Surgery is the main modality of treatment. Wound infection is the most commonly observed post-operative complication.Conclusions: Hollow viscus perforation leading to peritonitis is one of the most common emergencies faced by a general surgeon. Early presentation, Proper diagnosis and timely interventions decrease morbidity and mortality.

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.

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