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KMID : 0371319740160030001
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Journal of the Korean Surgical Society
1974 Volume.16 No. 3 p.1 ~ p.10
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Clinical review of Peritonitis Caused by Perforation of the Ileum due to Salmonellosis
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尹炳宅/Yoon, Byung Taek
孫基燮/Son, Ki Sub
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Abstract
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Clinical observation was made of 30 cases of surgical patients who were operated with perforation of the ileum secondary to salmonellosis, which were experienced from July, 1967 to Oct., 1973 at the department of general surgery of Chung Nam National University Hospital.
The results are as follow.
1. Recently the incidence of perforation of the ileum due to salmonellosis has a tendency to increase.
8 cases (26.7%)-in 1973, 8 cases (26.7%) in 1972, 7 cases (23.3%) in 1971,
3 cases (10.0% in 1970, 1 case in 1969, 2 cases in 1968, 1 case in 1967
2: The occurence´of salmonellosis was most frequent in summer.
3. Salmonellosis was occurred most frequently in those between the age of 20-29 years and the
male-female ratio was 2 : 1.
4. Perforation was developed most frequently at 11th to 20 the day after onset and the duration from perforation to operation was most frequent in 2 to 3 days.
5. 6 cases(20%) were operated within 24 hours after perforation, then there was no expired ,case, that was contributed to the decreased mortality rate.
6. Subdiaphragmatic free air in simple X-ray was found in 75% of perforated cases.
7. The site of intestinal perforation was within 60 cm. proximal to ileocecal region in 73. 3% of the perforated cases.
8. In surgical management, simple suture of the lesion was performed in 73.3% of the cases and end-to-end anastomosis after resection was done in 16.7%, exteriorization was done in 10..0%.
9. The incidence was higher in rural (77%) than in city (23%).
10. Complications after surgery were
wound infection: 23%, wound disruption: 14%, intestinal fistula: 7%, liver abscess: 3%, mortality rate: 30%.
11. In the hematologic finding on admission, the leucopenic change(below 6000/mm3 in W.B.C.) was in 43.3%.
12. The result of Widal test was positive in 47% (above 160X).
13. The diagnosis of ileal perforation was confirmed in all biopsied cases (12 cases) as salmonellosis.
14. The overall mortality rate was 30%.
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