LIÊN QUAN VỊ TRÍ DỊCH Ổ BỤNG TRÊN CẮT LỚP VI TÍNH VÀ BIẾN CHỨNG NHIỂM KHUẨN SAU MỔ THỦNG DẠ DÀY RUỘT

Abstract

Objectives: The aim of this study is to investigate the association between the localizing distribution of abdominal ascites on computed tomography (CT) and the postoperative complications in patients with gastrointestinal perforation (GIP). Subjects and methods: a cross-sectional descriptive study of GIP undergoing abdominal CT for diagnosis and surgical treatment at Viet-Duc Friendship Hospital from July 2022 to June 2023. 120 GIP patients, consisting of 86 males and 34 females with an average age of 54.9 ± 16.68 years (ranging from 21 to 90 years). The perforated localization was found to be jejunum - ileum in 41 (34.2%) patients, stomach - duodenum 36 (30.0%), sigmoid colon - rectum 27 (22.5%), duodenum 6 (5.0%) and colon 10 (8.3%). Postoperative complications included 51 (42%) case with sepsis, 39 (32.5%) septic shock and 21 (17.5%) mortality within 30 days after surgery. Results: The risk of sepsis decreased sequentially according to the location of the free abdominal fluid from right upper quadrant (OR 5.7; 95% CI 2.6-12.5; p<0.01), right lower quadrant (OR 4.1; 95% CI) CI 1.9-8.9; p < 0.01), lower left quadrant (OR 2.3; 95% CI 1.1-5.1; p < 0.05), inter-loops (OR 2.5; 95%CI 1.2-5.4; p < 0.05). The odds of postoperative septic shock increased gradually according to the location of the fluid from pelvis (OR 2.8; 95% CI 1.3 - 6.3; p < 0.01), left lowerquadrant (OR 2.8; 95%CI 1.2 - 6.3; p < 0.01), left upper quadrant (OR 3.3; 95% CI 1.4 - 7.9; p < 0.01), inter-loops (OR 4.3; 95% CI 1.9 - 9.6; p < 0.05), lower right quadrant (OR 5.0; 95%CI 2.2 - 11.5; p < 0.01), upper right quadrant (OR 5.2; 95% CI 2.3 - 11.9; p < 0.01). The odds of mortality within 30 days increased according to the location of the fluid sequentially from right upper quadrant (OR 4.8; 95%CI 1.8-13.2; p < 0.01), right lower quadrant (OR 4.2; 95%CI 1.5-11.7; p < 0.01), inter-loops (OR 3.3; 95% CI 1.2-8.6; p = 0.01). Conclusion: The localization of free abdominal fluid on CT is associated with the risk of complications in patients after surgery for GIP.