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

Akinori Egashira, Tomohiro Iguchi, Tadahiro Nozoe, Eisuke Adachi, Akito Matsukuma, Takahiro Ezaki, Yoshihiro Kakeji, Shunichi Tsujitani, Yoshihiko Maehara

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)56-65
Number of pages10
JournalFukuoka igaku zasshi = Hukuoka acta medica
Volume102
Issue number3
Publication statusPublished - Mar 2011

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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