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消化性 胃·十二指腸 潰瘍穿孔에 對한 臨床的 考察

Clinical Experience on Perforated Peptic Ulcers of Stomach and Duodenum

대한외과학회지 1968년 10권 7호 p.475 ~ 482
강금용, 현응설,
소속 상세정보
강금용 (  ) - 제116 육군병원 일반외과
현응설 (  ) - 제116 육군병원 일반외과

Abstract


A clinical review was made on 150 cases of perforated peptic ulcers of stomach and duodenum treated surgically at the 116th Army Hospital from July 1964 to January 1968.
1) The ratio of perforation between stomach and duodenum was about 3;1, 114 cases (76.0%) in stomach and 36 cases(24.0%) in duodenum were noted.
2) As a site of perforation, 63 cases (42.0%) of 150 cases were in pyloric region which indicated the highest number of occurrence and 34 cases(22.7%) of 150 cases were observed in first portion of duodenum.
3) Seasonal occurrence of perforation was predominant in cold season, from December to March.
4) The duration of symptom was 0-3 years in majority(72.7%).
5) Analysis of subjective symptoms revealed in order of epigastric pain (100%), nausea (98.7%), dizziness (87.3%), upper back pain (82.0%), chillness (70.0%), thirst (6.3%) and vomiting(54.7%).
6) Leucocytosis raging above 10,000 was noted in 69 cases(46%).
7) Of 150 cases, 53 cases(37.3%) belong to blood group B.
8) As the emergency surgical procedures, 101 cases(67.3%) were subjected to primary closures and 49 cases (32.7%) to prmiary resections.
9) Among 97 cases subjected to the secondary operation, Hofmeister´s type gastrojuno-anastomosis were performed in 82 cases (84.5%) and Hofmeister´s type procedures with concomitant vagotomy in 12 cases (12.4%).
10) The early post-operative complications were observed in 17 cases (11.3%) and hemorrhage (3.0%) and peritonitis (2.0%) were major complications among these cases.
11) As the late-complication, dyspepsia 8.7% and Dymping syndrome 4.0% were noted in 150 cases.
12) Post-operative mortality was 3.9% in primary closures, 4.1% in primary resections and 2.1% in secondary resections.
13) The over-all mortality of perforated peptic ulcers of stomach and duodenum was 5.3%.

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