The records of all patients undergoing surgical treatment due to ileal perforation, in Seoul
National University Hospital between January 1960 and July 1973, were reviewed and analyzed
,clinically, for the purpose of understanding clinical aspects of ileac perforation. The result obtained is as follows:
1. Ileal perforation was 17.8% of all the generalized peritonitis.
2. Of ileal perforations, 70.3 were caused by typhoid enteritis, 20.5% by. abdominal trauma, 4.8% ´by- intestinal tuberculosis and 4.4% by others.
3. Overall incidence of .deal perforation has not decreased for the past 13 years but typhoid enteritis tended to decrease and abdominal trauma to increase.
4. Of deal perforations, 62% occurred in the 3rd and 4th decade, 71.6% ´were males and 28.4% were females.
5. The patients undergoing surgical treatment within 24 hours were 48.9% in all; 42.8% in
-typhoid enteritis, 72. 3% in abdominal trauma and not in intestinal tuberculosis.
6. Dehydration, abdominal.pain and distension developed in ileac perforation but milder than do the other generalized peritonitis.
7. Of perforated typhoid enteritis, 64.0% occurred in the summer and autumn, 26.1% showed
Ieukopenia, 41. 5% were positive on widal test and 10.4,were positive on culture for salmonella. 8. Subdiaphragmatic free gas was shown in 63. 6% of typhoid enteritis, 80.6% of abdominal
-trauma and 9. 1% of intestinal tuberculosis on chest films.
9. Most of perforations were located 34.2±3.7 cm. proximal to the ileocecal junction in -typhoid enteritis, 100. 0±4. 7 cm. in abdominal trauma, 97.3±42.0 cm. in intestinal tuberculosis and 50.6±4.8 cm. in all.
10. Of ileal perforations, single perforation was 75. 1% and multiple perforation was 24.9%.
11. Most of perforated typhoid enteritis and intestinal tuberculosis were round and ovoid in shape and about 0. 5 cm. in size, but most of perforations due to abdominal trauma were irregular in shape and over 1. 0 cm. in size.
12. Of operative procedures performed 58. 1% were primary closure, 32. 7% were resection and anastomosis, 5. 7% were exteriorization and 3. 5% were external drainage.
13. The first of early postoperative complications was wound infection, being 66.1% and the next was fistula formation, being 8. 5%.
14. Causes of death were acute renal failure(42.3%), sepsis(30. 8%), asphyxia(9.2°% and cardiac failure(7. 7%).
15. Overall mortality of ilea]´ perforation was 11.4%. The longer the duration of perforation
prior to operation was, the higher the mortality was. The etiology of ileal perforation and the operative procedures performed made no differences in mortality.
16. Surgical treatment was preferred to medical treatment and the prognosis of resection and anastomosis preferred to that of primary closure.
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