BACKGROUND Peritonitis due to hollow viscus perforation is one of the common causes for emergency ward admission under surgery department. Its causes vary from the ones requiring immediate surgical intervention to those requiring conservative management. Its accurate diagnosis and management are a challenge to every surgeon. Scoring systems that provide objective descriptions of the patient's conditions at specific points in the disease process aid our understanding of these problems. Hence this study is undertaken to study the effectiveness of Mannheim's Peritonitis Index (MPI) in predicting the outcome in peritonitis patients who presented to Basaveshwara Teaching and General Hospital, Kalaburagi. MATERIALS AND METHODS This study is a clinical, prospective, observational and open study conducted at the department of General Surgery, Basaveshwar Teaching and General Hospital, Kalaburagi from July 2014 to March 2016. The sample size estimation was also done at convenience. RESULTS The mean age of the patients was 45.72 (SD 14.26) years. There was male preponderance (66%) with male to female ratio of 1.9:1. In our study, the most common aetiology of peritonitis was duodenal perforation seen in 70% of patients, followed by gastric perforation (13%), ileal (12%), jejunal (3%) and appendicular perforation (2%). CONCLUSION Various factors like age, sex, duration, site of perforation, extent of peritonitis and delay in surgical intervention are associated with morbidity and mortality. MPI scoring system is the easiest score to apply. It helps in the determination of the risk during operation and also helps the surgeon know about the possible outcome and the appropriate management. MPI is more effective in predicting the mortality in peritonitis due to hollow viscus perforation.
A 42-year-old male presented with a raised, painless growth over the anterior abdominal wall of more than six years duration. The clinical examination demonstrated a coneshaped horn-like growth [Figure-1]. After careful and detailed physical examination, the lesion was excised, and abdominal wall defect was repaired with satisfactory result. Specimen was evaluated microscopically. Microscopically, the horn consisted of a mixture of squamous epithelial cells and trichilemmal keratinised debris. The follow-up was uneventful without signs of recurrence. Sebaceous horn or cutaneous horn of anterior abdominal wall is a rare clinical entity. The case of a giant sebaceous horn on the anterior abdominal wall presenting in a 42-year-male, which was successfully excised, and defect repaired was reported. Cutaneous horn (Cornu cutaneum) is a relatively uncommon lesion consisting of a projectile, conical, dense, hyperkeratotic nodule, which resembles the horn of an animal. [1] The horn is composed of compacted keratin. Cutaneous horns most frequently occur in sun-exposed parts and are typically found on the face and scalp, but may also occur on the hands, penis, eyelids, nose, chest, neck and shoulder and rarely few cases have been reported where it presents itself on anterior abdominal wall. The cutaneous horns are usually benign; however, malignant or premalignant lesions might be associated with it. [2] Because of their malignant potential, the lesions must always be considered for histopathological evaluation.
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