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KMID : 0371319740160110019
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Journal of the Korean Surgical Society
1974 Volume.16 No. 11 p.19 ~ p.27
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The Analysis of 127 cases of Peptic Ulcer Perforation and Hemorrhage
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金榮哲/Kim, Young Chul
文洪永/金仁洙/黃正雄/Moon, Hong Yong/Kim, In Soo/Whang, Chung Woong
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Abstract
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A series of 127 cases of peptic ulcer patient with perforation and massive hemorrhage admitted to the dept. of surgery of woo sok hospital of Korea. University during June; 1968 to June, 1974 have been-analyzed as follows.
1) Among 127 cases, 30 cases (23.6%) were massive bleeding ulcer, and 97 cases were perforated ulcer, and ratio was 1 : 3.
2) The age of the majority of the cases ranged from 21~30 years (25.2%), next was 31~40 years (20.5%), and over 70 years are least (5.4%).
3) The sex distribution is 3 : 1, with male (106)and female (27).
4) Monthly incidence was high´ on spring and autumn.
5) Duration of symptoms was as follows 25.2% were between 3~4 years, 21.2% were within. 2 months.
6) In past history, indigestion was most common symptoms (48%), next epigastric pain (43.3%).
7) Physical examination revealed epigastric tenderness (75.3%) and abdominal rigidity (57.5%) in perforated ulcer cases. In massive bleeding ulcer, shock was most common finding (26.7%).
8) Upper G-I series revealed pathologic ulcer lesion in almost all bleeding cases. In perforated group, subdiaphragmatic free gas was noted in 71%. Abnormal hematologic finding was noted in 80.3%, and abnormal electrolyte value was noted in 22.8%.
9) A.B.H. type 0 was most common in patients.
10) The ratio of gastric and duodenal ulcer was 1.4 : 1 and most common size of ulcer was less, than 0.5cm (42.5%).
11) The postoperative histologic findings disclosed 3.9% of malignancy.
12) In operative procedures, massive bleeding ulcer was treated with Vagotomy and Pyloroplasty(53.3%). Subtotal gastrectomy (26.6%), Vagotomy and antrectomy (20.1%). Perforated ulcer was treated with Vagotomy and Pyloroplasty (41.2%), and Simple closure (38. 1%).
13) Most patient (64%) was admitted within 24 hours after onset of acute symptoms.
14) The early postoperative complications were 27 cases (21%). Wound infection was most frequent (8.7%).
15) The postoperative results during hospitalization were as follows: excellent, 37.8% good, 14.7%. The most of excellent group had Vagotomy and Pyloroplasty.
16) There was no death, but reoperation was performed in 2 cases. One had simple closure and the other had subtotal gastrectomy.
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