How to Grade? - Grey Zone Cases

Over the past five years, we were confronted with a couple of clinical cases, in which the grading of complications turned out to be difficult. Such cases were prospectively collected at our center.

 

 

Example of "grey zone cases"

 

 

 


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Scenario 7:
A 60-year-old diabetic patient underwent a rectal resection for adenocarcinoma in another facility. The patient had a long-term corticosteroid therapy due to a rheumatic disease. The patient developed abdominal pain, fever and leukocytosis 6 days later. A relaparotomy was performed, revealing an anastomotic insufficiency. The small pelvis was drained, and a protective ileostomy was performed. The patient was subsequently referred to us because of hemodynamic instability, but the patient died 3 days later in our ICU due to a fulminant sepsis.


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