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KMID : 0365719940100010095
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Journal of Pusan Surgical Society
1994 Volume.10 No. 1 p.95 ~ p.101
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Clinical Observation of Acute Colon Perforation
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Abstract
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During the period of 3 years from June 1991 to June 1994, the records of 27 patients with acute colon perforation who were admitted to Pusan Medical center were reviewed.
@ES The results were as follows :
@EN 1) The ages of the patients ranged from 20 to 70 years, with 51.1% occuring between 31 and 60 years. The ratio of male to female was 4.4 ; 1.
2) The causes of perforation were cancer in 9 cases(33.3%), stab in 6 cases(22.2%), obstruction in 6 cases(22.2%), inflammation in 3 cases(11.1%) and iatrogenic in 3 cases(11.1%).
3) The most common site of perforation was the sigmoid colon(11 cases, 40.7%), followed by ascending colon, transverse colon, descending colon and rectum.
4) The degree of contamination according to Flint's classification was grade II in 20 cases (74.1%), grade I in 6 cases(22.2%) and Grade III in 1 cases(3.7%).
5) The methods of operative treatment were variable, In the right colon perforation, resection and anastomosis was done in 5 cases(18.5%). In the left colon perforation, primary closure was done in 5 cases(18.5%), resection and anastomosis in 5
cases(18.5%), repair with proximal diversion in 8 cases(29.6%) and resection and diversion in 4 cases(14.8%). Overall 15 cases(55.6%) underwent primary closure or resection and anastomosis(primary repair group), 12 cases(44.4%) underwent repair
with
proximal diversion or resection and diversion(colostomy group).
6) The postoperative complications were occured in 19 cases(70.4%) and the most common complication (complication) was sepsis in 10 cases(37%). In the right colon perforation, complication developed in 2 cases(10.5%) and in the left colon
perforation
in 17 cases(89.4%).
7) The mortality rate was 33.3%(9 cases of total 27 cases) and the causes of death were septicemia and hypovolemic shock induced by bleeding.
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