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急性膽囊穿孔症에 對한 臨床的考察

A Statistical Observation and Their Clinical Review of Gall Bladder Perforation

대한외과학회지 1966년 8권 5호 p.279 ~ 282
김승완,
소속 상세정보
김승완 (  ) - 전남대학교 의과대학 외과학교실

Abstract


Clinical review is made 13 patients of gall bladder perforation who received surgical intervention at Chonnam University Hospital for 5 years from 1960 to 1964.
1) Incidence of perforation was 10.401/0 of acute cholecystitis. In the 13 cases, 8 cases (61.5/,) were of the Niemeie rtype I, 5 cases (38.5%) were of the Niemeier type 11.
2) The average age of patients was 48 years and in the majority age ranged for 9 to 68 years. The 5 (38.5%) patients were men and the 8 (61.5%) patients were female.
The ratio of male to female was 2 to 3.
3) Duration of symptoms was as follows; within 4 days, 69.2% perforated. All perforated within 7 days. A history of no previous attack was obtained 77%.
4) Symptoms and signs were RUQ pain 13 cases( 100%), vomiting(69.2%), generalized abdominal pain (76.9%), diffuse tenderness (84.6 %), abdominal distension (61.9%) and jaundice( 30.8%).
5) The pre-operative diagnosis was difficult. The gall blader perforation was 38.5%.
The operation was cholecystectomy with common duct exploration( 61.5%), cholecystectomy(23.1%), and cholecystostomy(15.4%).
The four deaths occurred in this series; A mortality of 30.8%.
The commonest cause of death was peritonitis.
6) In the culture of peritoneal fluid and abscess, E. coli was 27%.

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