This report is a clinical analysis of 131 patients with severe intra abdominal abscess who were admitted to Intensive Care Unit at department of general surgery, WMBH during the past 8 years from January 1,1984 to December 31, 1991.
@ES The results were as follows:
@EN 1) The mean age was 53 years and male to female ratio was 1.6:1.
2) The common sites of disease were pancreas, small bowel and colon, which were 20%, 20% and 16% of all abscesses, respectively.
3) Positive culture was obtained in 24 out of 31 cases and the frequent culture organisms were E. coli(24%) and enterobactor(14%).
4) The most common symptoms were fever and chill, the other symptoms and signs were abdominal pain and tenderness, jaundice, palpable mass and drainage pus.
5) All the anatomical location of abscess were intraperitoneal and visceral. Among them, most abscess(71%) were located in the interloop(25%), pancreas(25%) and subphrenic space(21%).
6) The mean APACHE II score was 15. All patients whose APACHE II score was over 26 were died, but below 10 were survived. (P value>0.05).
7) The mean serum albumin level was 2.7, but it was decreased to 2.3 in the expired patients.
8) The methods of treatment were operative drainage with TPN(87%), nonoperative percutaneous drainage with TPN(10%) and TPN alone(3%).
9) The common complications were wound infection(28%), ileus(17%), pulmonary complication(17%), peritonitis(14%), bleeding(11%), sepsis(6%), enterocutaneous fistula(4%), hepatic fail ure(3%).
10) The mortality rate ws 29% and the risk groups of high mortality were the old age, low serum albumin level and high APACHE II score.
11) The major causes of death were sepsis(45%) and bleeding(22%).
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