" IMPACT OF PERI-OPERATIVE ACUTE CARE AS PREDICTORS OF OUTCOME IN EMERGENCY LAPAROTOMY FOR GANGRENOUS BOWEL: INSIGHTS OF A PROSPECTIVE ANALYSIS FROM A TERTIARY INDIAN CENTRE " singhsaumya16@yahoo.com

 

" IMPACT OF PERI-OPERATIVE ACUTE CARE AS PREDICTORS OF OUTCOME IN EMERGENCY LAPAROTOMY FOR GANGRENOUS BOWEL: INSIGHTS OF A PROSPECTIVE ANALYSIS FROM A TERTIARY INDIAN CENTRE "

4

India

Poster with Discussion

Gangrenous bowel is a life-threatening surgical emergency often presenting with vague symptoms. Early diagnosis and prompt surgical intervention are vital for improving outcomes. This prospective analysis evaluates the role of acute care parameters in predicting outcomes following emergency laparotomy for gangrenous bowel.

Seven patients presenting with clinical features suggestive of bowel ischemia or obstruction were admitted through the emergency department at King George’s Medical University, Lucknow. All patients underwent structured evaluation using clinical, biochemical (including serum lactate, leukocyte count), and radiological parameters (CT imaging) prior to emergency surgical exploration. Data on demographics, etiology, intraoperative findings, and postoperative outcomes were recorded and analyzed.

Etiologies included thromboembolic occlusion (43%) and mechanical causes such as hernia, adhesions, and Peutz-Jeghers syndrome-related intussusception (57%). Key predictors of poor outcomes were delayed presentation, elevated serum lactate, leukocytosis, and CT findings indicative of bowel compromise. Among the seven patients, five recovered postoperatively with lengths of stay ranging from 5 to 40 days, while two succumbed to sepsis and multi-organ dysfunction. Early surgical decision-making based on acute care triage was crucial to improving survival.

Acute care assessment plays a critical role in the early recognition and effective management of gangrenous bowel. Serum lactate, leukocyte count, and CT imaging are useful predictors of disease severity and should be integrated into triage protocols. This study underscores the need for standardized acute care pathways to guide timely intervention, especially in resource-limited settings.