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腸重疊症 328例

328 Cases of Intussusception

중앙의학 1964년 7권 1호 p.61 ~ 68
김경식, 白樂晥,
소속 상세정보
김경식 (  ) - 서울백병원외과
白樂晥 (  ) - 서울白病院外科

Abstract


Between June 1953 to Joune 1963, total 328 Cases of intussusception have been treated at The Paik Clinic, Seoul. Out of these total, 154 cases covering the period between june 1953 .through May 1956 have been previously reported from this Clinic, and the present report deals with 174 Cases representing all cases seen after May 1956.
1) Age; 29 Cases(16.6%) were below 1 year of age, 80 cases (45.9%) were between 1 and 15 years of age and the rest, 94 Case (54.1%) represented the adult population.
2) Sex; Male dominated at the ratio of 76.4% to females 23.6%
3) Cause; In only 15 Cases (8.7%), a cause considered responisble for the Intususception could be discovered. Out of these 15 eases, 10 were children. 159 Cases, or 91.3% of total were idiopathic in which no cause could be discovered.
4) Symptoms
a) Abdominal pain was present in all cases(100%)
b) Vomiting was seen in 62%
This was a commoner symptom in Children (80%) while it occured in about half the adult cases (47.9%)
c) Melena was in only 5.3% of adult cases while it -occured in 50% of children.
d) Palpable tumor was present in 72. 4% of adult cases and 94% of children, an overall palpability of 81.2%, It was felt in 57.2% at right lower quadrant, 18.9% at right upper quadrand, 14, 6% at mid upper abdomen, 5.6% at left upper quadrant and in 2%, the mass was described in periumbilical area.
5) Type of intussusception;
In children, ileocecal type was the commonest (56,5%) followed by colocolonic (43.5%). In adult, colo-colonic type was by far the commonest (71.3%) followed by ileo-colic (25.5%) and ileo-ileal (2.1%).
6) Treatment
Except the 4 cases inwhich reduction was accomplishel by barium enema, 170cases were treated by surgery including the cases in which intestinal resection was required.
7) Mortality
Overall mortality was 4% (7 cases) all of these were children, and 6 out of these 7 were under 1 year of age.
Mortality of children, therefore was 83% and that of infant under 1 year ofage was 20.7%.

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