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Gupta, Sanjay; Kaushik, Robin

doi:10.1186/1749-7922-1-13

Cited by 64 publications

(27 citation statements)

References 36 publications

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“…However, the incidence remains high in India and other developing countries where costs may limit such therapy [26]. The mortality of 20% in this series is similar to other series from India (6–26%) [26] and some reports from Europe (11–29%) [1, 28]. The main cause of morbidity and mortality among patients with peritonitis is MSOF and septic shock.…”

Section: Discussionsupporting

confidence: 76%

“…Duodenal ulcer perforation was the commonest cause in this study and is the commonest cause of secondary peritonitis in India [25, 26]. The morbidity and mortality associated with duodenal ulcer perforation is decreasing in developed countries due to widespread use of proton pump inhibitors and Helicobacter eradication therapy [27].…”

Section: Discussionmentioning

confidence: 99%

“…The morbidity and mortality associated with duodenal ulcer perforation is decreasing in developed countries due to widespread use of proton pump inhibitors and Helicobacter eradication therapy [27]. However, the incidence remains high in India and other developing countries where costs may limit such therapy [26]. The mortality of 20% in this series is similar to other series from India (6–26%) [26] and some reports from Europe (11–29%) [1, 28].…”

Section: Discussionmentioning

confidence: 99%

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Free Radical and Antioxidant Levels in Patients with Secondary Peritonitis and Their Prognostic Significance

2007

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Background: The clinical outcome of patients with secondary bacterial peritonitis depends on the production of superoxides involved in bacterial killing and the endogenous level of antioxidants. The prognostic significance of their levels has not previously been investigated. Patients and Methods: Forty-five patients undergoing surgery for secondary peritonitis were prospectively evaluated. Severity of illness at admission (APACHE II score) was correlated with admission levels of superoxide radicals and antioxidants (superoxide dismutase (SOD), catalase and glutathione peroxidase). Levels were compared with general surgery controls (n = 10). Superoxide and antioxidant levels at admission (day 1) and post-operative days 3 and 5/7 were then correlated with outcome. Results: Nine of the 45 patients died (20% mortality) and 17 patients had complications (47% morbidity). The mean APACHE II score on admission was significantly higher among non-survivors than survivors (p < 0.01). The APACHE II score on admission correlated with the level of free radicals (r = 0.477, p < 0.01), catalase (r = –0.489, p < 0.01) and SOD (r = –0.357, p < 0.05). Admission superoxide levels were higher and antioxidant levels lower in peritonitis patients than controls. Levels did not significantly change following surgical intervention and post-operative levels did not correlate with outcome. Conclusion: The levels of superoxide and antioxidants correlate with the severity of illness on admission in patients with secondary peritonitis, but serial levels following surgical intervention do not predict outcome.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Free Radical and Antioxidant Levels in Patients with Secondary Peritonitis and Their Prognostic Significance

2007

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“…Ileal perforation as complication of typhoid fever and enteritis is a major public health problem in many areas worldwide because of its persistent high morbidity and mortality. Typhoid ileal perforations have a mortality rate up to 60% [138]. In the CIAOW study, according to stepwise multivariate analysis, the presence of small bowel perforation was an independent variable predictive of mortality [139].…”

Section: Small Bowel Perforationsmentioning

confidence: 99%

The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

et al. 2017

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Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide.The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important.In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs.The aim of this paper is to promote global standards of care in IAIs and update the 2013 WSES guidelines for management of intra-abdominal infections.

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“…These typhoid ileal perforations have a mortality rate up to 60% [66]. Early surgery is associated with a better outcome.…”

Section: Source Controlmentioning

confidence: 99%

A focus on intra-abdominal infections

2010

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Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients.Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials.Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection.Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures.The cornerstones in the management of complicated intra-abdominal infections are both source control and antibiotic therapy.The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections, because inadequate and late control of septic source may have a negative effect on the outcomes.Recent advances in interventional and more aggressive techniques could significantly decrease the morbidity and mortality of physiologically severe complicated intra-abdominal infections, even if these are still being debated and are yet not validated by limited prospective trials.Empiric antimicrobial therapy is nevertheless important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance.Antimicrobial management is generally standardised and many regimens, either with monotherapy or combination therapy, have proven their efficacy. Routine coverage especially against Enterococci and candida spp is not always recommended, but can be useful in particular clinical conditions. A de escalation approach may be recommended in patients with specific risk factors for multidrug resistant infections such as immunodeficiency and prolonged antibacterial exposure.Therapy should focus on the obtainment of adequate source control and adequate use of antimicrobial therapy dictated by individual patient risk factors. Other critical issues remain debated and more controversies are still open mainly because of the limited number of randomized controlled trials.

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Untitled

Cited by 64 publications

References 36 publications

Free Radical and Antioxidant Levels in Patients with Secondary Peritonitis and Their Prognostic Significance

Free Radical and Antioxidant Levels in Patients with Secondary Peritonitis and Their Prognostic Significance

The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections

A focus on intra-abdominal infections

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