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Salmonellosis 에 依한 廻腸末端穿孔의 外科的 觀察

Clinical Observations on Patients with Terminal Ileal Perforation due to Salmonellosis

대한외과학회지 1969년 11권 9호 p.583 ~ 587
黃瀚旭, 宋益薰,
소속 상세정보
黃瀚旭 (  ) - 第59後送病院 外科
宋益薰 (  ) - 第59後送病院 外科

Abstract


Among the 239 cases of salmonellosis patient, clinical observation was made for 23 cases of surgical patient who were operated between April 1968 and March 1969 at the Department of surgery, 59th Evacuation hospital under the diagnosis of terminal ileal perforation which were suspected to be caused by the infection of salmonella.
The results were as follows.
1) The mojority of infection of salmonellosis occured in April (78 cases. 32.6%), september (71 cases. 29%) and December (42 cases. 17.5%). Some other salmonellosis patients occured even in other months. Whole cases were 3rd decade of male, because the all cases were army service man.
2) Perforation were developed mostly (52.2%) from 10 to 20 days from the onset of disease. 56% of perforated cases were operated within 24 hrs. after the onset of perforation.
3) Although multiple perforations were encountered in some patients, 60.8% of cases had only one perforation. In 69.5% of cases the site of perforation was within 20 to 40 cm. from ileocecal junction.
4) Widal test were repeated three times, then 59% of cases revealed positive result. Stool culture revealed positive in 19% of cases.
5) Subphrenic free air shadow was detected in 56.5% of perforated cases in X-ray.
6) Simple closure was done in 78.3% of perforated cases. Intestinal resection and end to end anastomosis was done in 13% of cases.
7) Wound infection was developed in 52% of operated cases as a most complication. Fecal fistula and pulmonary complication were developed in 21% of cases in each.
8) Mortality rate after operation was 13% in 23 cases of surgical patients, and 2.92% of mortality rate in 239 cases of salmonellosis patients.

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