Thesis (M.Sc.)-Cairo University, 2023.ة

Bibliography: pages 80-85.

Background
Peritonitis was recognized as a universal fatal condition from the earliest of
times. Peritonitis is defined as inflammation of the peritoneal cavity, caused
by several etiological agents, including bacteria, fungi, viruses, chemical
irritants, and foreign bodies. The scoring systems enable surgeons to assess
the severity of the disease. The Acute Physiological and Chronic Health
Evaluation Score (APACHE II) and Mannheim’s peritonitis index (MPI) are
most commonly used.
Aims and objective
To compare the effectiveness of Mannheim peritonitis index vs. APACHE II
score in predicting morbidity and mortality in patients with peritonitis due to
hollow viscus perforation
Methods
A cohort (Longitudinal) study was conducted in 50 patients with peritonitis
due to hollow viscous perforation between January 2022 and May 2023 at
emergency department of Kasr AlAiny, Faculty of Medicine, Cairo
University. All data was recorded. Written informed consent was obtained
and data were analyzed using an appropriate analytical strategy.
Result
Out of 50 patients presented with acute abdomen, Mean age was 42.1 ±16.8
years.Male patients were 39 female patients were11. Patients diagnosed with
perforated prepyloric ulcer were 23, perforated appendix were17, perforated
small bowel were 10, perforated sigmoid were 3, and 2 patients with
perforated gastric ulcer. The mean APACHE II score of 50 patients was 10.3
± 5 ranging from 2-24,MPI score was 19 ± 8.3 with ranging from 0-36. mean
length of hospital stay was 8.6 ± 10 days with a median of 6 days ranging




II



from 1-49. sensitivity analysis showed that Mannheim’s peritonitis index,
APACHE score can significantly predict incidence of morbidity with p value
0.002, 0.03, using cutoff point 16.5and 13.5 with sensitivity 88.9% and
55.6% with specificity 61.3%, 90.3% respectively. sensitivity analysis
showed Mannheim's peritonitis index, and APACHE points can’t
significantly predict incidence of mortality with p value >0.05.
Conclusion
We concluded that both MPI and APACHE scores equally good in predicting
incidence of morbidity in secondary peritonitis patients due to hollow viscus
perforation. But they cannot significantly predict incidence of mortality in
those patients.

ان التهاب التجويف البريتونى يعد من الحالات المميتة منذ أقدم العصور، ناجم ناتج عن العديد من العوامل المسببة، بما في ذلك البكتيريا والفطريات والفيروسات والمهيجات الكيميائية والأجسام الغريبة. تتيح أنظمة التسجيل للجراحين تقييم مدى خطورة المرض. تتعتبر درجة تقييم الصحة الفسيولوجية والمزمنة الحادة (نقاط أباتشى) ومؤشر التهاب البريتونى في لمانهايم (MPI) الأكثر استخدامًا.
تهدف هذه الاطروحة للمقارنة بين هاتيذين النظامين الطريقتين لتحديد مدى فاعلية كل منهما فى التنبؤ بالمراضة والوفيات لدى مرضى التهاب البريتونى بسبب انثقاب الاحشاءالمجوفة .
وقد استنتجنا ان كلا الجهازين الطريقتين لديهم نفس الفاعلية ف القدرة على التنبؤ بالمراضة وعدم القدرة على التنبؤ بالوفيات فى مرضى التهاب البريتونى بسبب انثقاب الاحشاءالمجوفة

Issued also as CD

Text in English and abstract in Arabic & English.