title: Predicting the amount of intraperitoneal fluid accumulation by computed tomography and its clinical use in patients with perforated peptic ulcer.
abstract: The correlation between the amount of peritoneal fluid and clinical parameters in patients with perforated peptic ulcer (PPU) has not been investigated. The authors' objective was to derive a reliable formula for determining the amount of peritoneal fluid in patients with PPU before surgery, and to evaluate the correlation between the estimated amount of peritoneal fluid and clinical parameters. We investigated 62 consecutive patients who underwent emergency surgery for PPU, and in whom prediction of the amount of accumulated intraperitoneal fluid was possible by computed tomography (CT) using the methods described by Oriuchi et al. We examined the relationship between the predicted amount of accumulated intraperitoneal fluid and that measured during surgery, and the relationship between the amount of fluid predicted preoperatively or measured during surgery and several clinical parameters. There was a significant positive correlation between the amount of fluid predicted by CT scan and that measured during surgery. When patients with gastric ulcer and duodenal ulcer were analyzed collectively, the predicted amount of intraperitoneal fluid and the amount measured during surgery were each associated with the period from onset until CT scan, perforation size, the Mannheim peritoneal index, and the severity of postoperative complications according to the Clavien-Dindo classification. Our present results suggest that the method of Oriuchi et al is useful for predicting the amount of accumulated intraperitoneal fluid in patients with PPU, and that this would be potentially helpful for treatment decision-making and estimating the severity of postoperative complications.
authors.affiliation: Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ishiguro
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kumagai
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Baba
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tajima
authors.forename: Hideko
authors.initials: H
authors.lastname: Imaizumi
authors.forename: Okihide
authors.initials: O
authors.lastname: Suzuki
authors.forename: Koki
authors.initials: K
authors.lastname: Kuwabara
authors.forename: Takeaki
authors.initials: T
authors.lastname: Matsuzawa
authors.forename: Jun
authors.initials: J
authors.lastname: Sobajima
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Ishibashi
authors.forename: Erito
authors.initials: E
authors.lastname: Mochiki
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ishida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000378:metabolism*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000000981:diagnostic imaging* / Q000601:surgery*; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Duodenal ulcer; Gastric ulcer; Peptic ulcer; Perforation; Peritoneal fluid