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KMID : 0371319750170040037
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Journal of the Korean Surgical Society
1975 Volume.17 No. 4 p.37 ~ p.43
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Surgical Review For Perforation of Gastroduodenal Ulcer
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李相健/Lee, Sang Keun
潘西雄/李璿根/黃圭哲/Bahn, Suh, Woong/Lee, Sun Geun/Whang, K.C.
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Abstract
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This report is a clinical review of 206 patients of perforated gastroduodenal ulcer which were treated in the department of surgery in Yonsei Medical Center from January, 1963 to December, 1974 in whole, and the result as follow: .
1. Among these 206 patients of perforated gastroduodenal ulcer, gastric ulcer were in 119 cases (57.9%), and duodenal ulcer were in 877 cases (42.2%). The ratio of perforated gastric and duodenal ulcer was 1.4 1-
2. The age incidence of perforated gastroduodenal ulcer occur in any age-but the peak incidence was third decade in male and 6th decade in. female. The incidence of female was gradually increased with age.
3. The monthly distribution of perforated gastroduodenal ulcer in these cases showed no difference, however, there is slightly increase its incidence during late spring and autumn.
4. Among these group, 125 cases (66.7%) of patients had a history of ulcer symptoms over -one year and 56 cases (27. 1%) had over 5 years.
5. The positive findings are included as follow: Direct tenderness of the, abdomen were found in 118 cases (86.4%), rebound tenderness in 122 cases (59.2%) and subdiaphragmatic free air shadows were found in 113 cases (64.9%).
6. The choice of the operation all as follow;
(1) Simple slosure in 103 cases (50%).
(2) Immediate gastrectomy in 45 cases (21.8%).
(3) Hemigastrectomy with bilateral vagotomy in 18 cases (8.8%).
(4) Pyloroplasty with bilateral vagotomy in 40 cases (19.4%).
7. All motality rate in all cases was in 9 cases (4.3%). The motality rate of simple closure was in 8 cases (7.8%) and immediate gastrectomy was in 1 case (0.8%)-
8. The result of immediate gastrectomy for perforated gastroduodenal ulcer was as good as simple closure procedure.
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