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急性腹膜炎의 統計的 考察

Statistical Study of Acute Peritonitis

최신의학 1969년 12권 11호 p.54 ~ 60
池三峰, 金子勳, 李秉化,
소속 상세정보
池三峰 (  ) - 서울대학교 醫科大學 外科學敎室
金子勳 (  ) - 서울대학교 醫科大學 外科學敎室
李秉化 (  ) - 서울대학교 醫科大學 外科學敎室

Abstract


Two hundreds and three patients with acute peritonitis who had admitted to the S. N. U. Hospital during the past 5 years (1957 to 1962) were statistically studied. Of 203 patients, 199 cases (diffuse 165, localized 34) were subjected to surgery and 4 cases to conservative treatment.
The results were as follows:
1. The operatively confirmed primary sites were: 70 perforation of appendix, 35 perforation of small intestine, 28 perforation of stomach and duodenum, 14 associated with internal genital, 11 acute pancreatitis, 10 rupture of liver and spleen, 8 perforation of gall-bladder, 6 rupture of adjacent abscess, 4 perforation of colon, 3 embolism of mesenteric artery and 3 unknown origin.
2. The conservatively treated 4 cases were 2 cases of stomach perforation, 1 pneumococcal and 1 streptococcal peritonitis; they were cured uneventfully.
3. Out of the whole group 170 patients (83. 7%) were discharged in 3 to 4 weeks and 13 after 5 to 7 weeks.
4. Complication developed in 15 cases (7.3%) and death occurred in 6 of them; it comprises 6 ileus, 3 fecal fistula, 2 uremia (died), 2 hemorrhagic shock (died), 1 cerebral embolism (died) and 1 acute cardiac arrest(died).
5. There were 20 deaths, a mortality rate of 9.8%: they were 14 cases toxemia and 6 of the abovementioned complications.
6. The mortality rate with the time interval between onset of the disease and operation, in comparison of 14 cases of toxemia to 165 patients with acute diffuse peritonitis, was 1 death (3.3%) out of 63 patients operated on- within 12 hours, 1(3.3%) out of 30 in 12-24 hours, 4(10%) out of 40 in 24-48 hours and 8 (29%) out of 28 in 2-5 days. This fact shows obviously that the delay of operation increases the mortality rate of the disease.

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