Risk-Associated Mortality in Patients with Peritonitis
Due to Sandorica Koetjape Seed Ingestion:
A Retrospective Study
Somdej Changsrisuk MD*,
Somchai Chutipongtanate PhD, MD**
Affiliation :
* Department of Surgery, Chaopraya Yommaraj Hospital, Suphanburi, Thailand
** Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : To identify the factor associated with the mortality of patients with peritonitis due to Sandoricum koetjape seed
ingestion.
Material and Method: Thirty patients who presented with peritonitis and had a history of Sandorica seed ingestion between
September 2009 and August 2012 were retrospectively reviewed. Gender, age, comorbid, number of ingested seed, duration
of symptom, body temperature, shock at initial admission, extent of peritonitis, presence of free air under the dome of the
diaphragm, white blood cell count, serum bicarbonate levels, resuscitation time, severity of intraabdominal contamination,
perforated wound size, and operation methods were analyzed for their association with the mortality using Fisher’s exact
test. Odds ratio (OR) and 95% confidence interval (CI) were calculated to determine the strength of association.
Results : All patients received a definite diagnosis of Sandorica seed-induced colon perforation intraoperatively. Six of 30
patients died during 28-day hospitalization. The result showed that shock at initial admission (OR 35.0, 95% CI 2.9-411.4,
p = 0.002), serum bicarbonate levels less than 15 mmol/L (OR 19.0, 95% CI 1.7-201.6, p = 0.009), and severe intraabdominal
contamination (OR 10.0, 95% CI 1.3-74.5, p = 0.029) were the significant factors associated with the mortality.
Conclusion : The factor-associated mortality in patients with peritonitis due to Sandorica seed ingestion was consistent
with a clinical picture of septic shock. Early recognition and treatment of hypotensive episode accompanying with surgical
correction and control of infection is therefore a key to improve the mortality outcome of this group of patients.
Keywords : Mortality, Colon perforation, Risk factor, Sandorica seed
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