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소화성 위, 십이지장궤양 천공에 대한 임상적 관찰 A Clinical review of Gastroduodenal Ulcer Perforations

대한외과학회지 1977년 19권 3호 p.27 ~ 34
최희순, 崔昌大,
소속 상세정보
최희순 (  ) 
경북대학교 의과대학 외과학교실

崔昌大 (  ) 
경북대학교 의과대학 외과학교실

Abstract


A clinical review was made on 199 cases of perforated gastroduodenal ulcer which were treated surgically in Kyung Pook National University Hospital from January 1962 to March 1975. The result as, follow:
1. Among 199 cases of perforated gastroduodenal ulcer, gastric ulcers were in 60 cases (30.2%) and duodenal ulcers were in 139 cases (69.8%). The ratio of perforated gastric and duodenal ulcer was 1:2.3.
2. Sex distributions were 180 in males and 19 in females with a ratio of 10:11. The peak of age incidence was fourth and fifth decades in male and fifth and sixth decades in female. 3. The seasonal distribution was prominent in summer.
4. 180 cases (90.5%) of patient had a history of ulcer symptoms.. prior to perforation. 66 cases (33.2%.) had over 5 years.
5. The subdiaphragmatic free air was seen in 154 cases (76.7%).
6. The -ratio of site of perforation, in body, antrum, pylorus, and first portion of duodenum
was 6.1%, 24.1%, 24.6%, and 45.2% respectively, and´ the -anterior wall in 191 cases (96%). 7. The operative procedures as follow:
simple closure ; 70 (35.2%)
immediate gastrectomy ; 34 (17.1%) vagotomy and hemigastrectomy; ; 97 C 3.5%)
vagotomy and drainage ; 74 (37.2%) .
gastrojejunostomy ; 14 C 7.0%)
8. The postoperative complications were noted in 68 cases (38%) including 35 cases (17.6%) of wound infection of variable severity.
9. The postoperative mortality rate was 9%(18 cases), and the most common cause of death was peritonitis and septicemia. The mortality rate of simple closure was in 13 cases (6.5%) and definite operation in I case (2.5%).

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