| [ Summary ] |
The gangrenous type and strictural type of ischemic colitis require surgery. For early diagnosis of the gangrenous type, confirmation of the existence of SIRS on admission and in the preoperative period for SIRS is useful. To decide on the strategy for therapy for severe cases, APACHE II and SOFA scores are very useful. In patients with panperitonitis operated on in our hospital, the death rate was higher in cases where the patient had preoperative APACHE II scores over 19, or SOFA scores over 6. PMX-DHP was effective in patients with APACHE II scores under 21, and SOFA scores under 11. It is believed that PMX is effective for treatment of patients with gangrenous ischemic colitis, and that if both scores are markedly high preoperatively, additional therapy may be necessary for improving the prognosis. |