Clinical observation was made of 213 cases of surgical patients who were operated on between
Nov. 1956 and June, 1969 at the department of general surgery of P.N.U. Hospital under the
diagnosis of generalized peritonitis due to small bowel perforations which were suspected to be caused
by the infection of Salmonella.
The results obtained were as following.
1. if 213 cases during 12 years and 8 months, high incidence occured in 1958 (14.1%), 1968
(12.2%) and 1965(11.3%) in order.
2. The age in majority of the patients was between the age of 11 to 30 years(55.4%). The
ratio of frequency between male and female 2.2:1.
3. In the monthly difference, high incidence was observed in Nov. (14.1%), Sep.(12.7%) and
Dec. (12.7%). In seasonal incidence, there was high in autum (34.3%), winter(28.2%) and
summer(27.3%) in order.
4. In 88 cases (41.3%), perforation developed at 11 to 20 days after onset and in 111 cases
(56.7%), the duration from perforation to operation was within 1 day.
5. The common sumptoms and signs were abdominal pain and distention including remarkabale
general weakness and dehyration after irregular febrile episode and those due to acute peritonitis
accompanied by perforation of G-I tract.
6. In the hematologic findings, the mortality was high in leukopenia, anemia, neutropenia and
lymphocytosis.
7. Widal test was positive in 45 cases (41.3%) out of 109 cases and 43 cases were diagnosed by
biopsy of the lesion and positive culture for Salmonella was observed in 7 cases out of 63 cases
from blood, stool, urine and pus.
8. X-ray findings revealed subdiaphragmatic free gas in 122 cases (65.5%) and with signs of
paralytic ileus in 41 cases(21.4%).
9. In operative findings, the site of perforation of most cases (91.6%) was within 50㎝ from
the ileocecal junction, the diameter of perforation was single in 173 cases (81.2%), the size of
0.3㎝ in diameter of perforation was in 62 cases(23.5%) out of 264 perforations and the shape
of perforation was mostly round and ovoid (96.9%).
10. The operative procedures were simple closure for 105 cases (49.3%), segmental resection
with end to end to anastomosis for 97 cases (45.5%), ileostomy for 6 cases(2.8%) and abdominal
drainage for 5 cases (2.4%).
11. The most frequent complication was 70 cases (65.4%) of wound infection and disruption.
12. The deaths during hospitalization were 38 cases with an overall mortality of 17.8%, which
included 19% of simple closure and 16.5% of ileal resection.
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