Assessment of predictors of mortality and severity in patients with colorectal perforation

Colorectal perforation is a life-threatening disease with high mortality and morbidity. The correct and prompt diagnosis and accurate judgment of severity are necessary. We retrospectively investigated 30 patients with colorectal perforation to assess predictors of mortality and severity, and evalua...

Full description

Saved in:
Bibliographic Details
Published inFukuoka igaku zasshi = Hukuoka acta medica Vol. 102; no. 3; p. 56
Main Authors Egashira, Akinori, Iguchi, Tomohiro, Nozoe, Tadahiro, Adachi, Eisuke, Matsukuma, Akito, Ezaki, Takahiro, Kakeji, Yoshihiro, Tsujitani, Shunichi, Maehara, Yoshihiko
Format Journal Article
LanguageEnglish
Published Japan 01.03.2011
Subjects
Adult
Aged
Aged, 80 and over
Colonic Diseases - diagnosis
Colonic Diseases - mortality
Female
Humans
Intestinal Perforation - diagnosis
Intestinal Perforation - mortality
Male
Middle Aged
Prognosis
Rectal Diseases - diagnosis
Rectal Diseases - mortality
Retrospective Studies
Severity of Illness Index
Tomography, X-Ray Computed
Online AccessGet more information

Cover

More Information
Summary:Colorectal perforation is a life-threatening disease with high mortality and morbidity. The correct and prompt diagnosis and accurate judgment of severity are necessary. We retrospectively investigated 30 patients with colorectal perforation to assess predictors of mortality and severity, and evaluated the usefulness of computed tomography (CT) for the initial diagnosis. The severity of peritonitis was assessed using clinical factors and Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) scores. Abdominal free air was detected by CT in 92% of patients with colorectal perforation, whereas only 36.6% showed evidence of abdominal free air by conventional radiography. The perforation site was correctly diagnosed in 14 of 25 cases (56%). Overall mortality was 16.7%. Survivors were younger than nonsurvivors, and POSSUM physiological and mortality scores were significantly lower for survivors compared with nonsurvivors. The amount of intraperitoneal soiling by large bowel content determined disease severity in terms of the need for postoperative respiratory management. In conclusion, CT is necessary for precise diagnosis, and the POSSUM score is helpful for the evaluation of disease mortality and severity.
ISSN:0016-254X