Clinical characteristics of lower bowel perforation with chronic renal failure

Background/Aims: This study was conducted to evaluate the clinical characteristics of lower bowel perforation (LBP) with chronic renal failure (CRF). Methodology: In 58 patients with LBP, clinical variables, such as findings of clinical examinations, operative findings, and results of laboratory blood tests were examined as possible prognostic factors for in-hospital death, and compared between CRF and non-CRF groups. Results: Of the 58 patients, 21 died during hospitalization (mortality rate, 36.2%). The mortality rate of patients with CRF was 54.2%. In the patients with LBP, the following variables were significantly correlated with in-hospital death (p<0.05): hypotension, CRF, fecal peritonitis, and low white blood cell (WBC) count, and low albumin and base excess (BE) levels. The odds ratios of in-hospital death were highest for a WBC count of 9000/mm³ and a BE of -3mEq/L. Between the CRF and non-CRF groups, significant differences in the rates of age <70 years, fecal peritonitis, in-hospital death, and low WBC count and BE were found (p<0.05). Conclusions: We identified prognostic factors of LBP and demonstrated the clinical characteristics of LBP with CRF. These results indicate that patients who have LBP with CRF tend to have immediate sepsis and a poor prognosis.