|
KMID : 0371319770190050023
|
|
Journal of the Korean Surgical Society
1977 Volume.19 No. 5 p.23 ~ p.32
|
|
|
Clinical Observation of Pediatic Surgical Diseases
|
|
閔漢基/Min, Han Gee
文洪永/崔鍾浩/羅正成/黃正雄/Moon, Hong Young/Choi, Jong Ho/Rha, Jung Sung/Whang, Jung Wung
|
|
|
Abstract
|
|
|
Authors have presented a statistical observation of 711 cases of pediatric surgical Patients under 15 years of age treated at Dept. of surgery, Korea University, College of Medicine during recent 10 years.
The result obtained were as follows:
1. The proportion of -main diseases are as follows: Appendicitis (97) 18.91% Hernia (82) 15.98% Intussusception (63) 12.28% Burn (61) 11.89% Various accidents (48) 9.36% Imperfora-ted anus (40) 7.80% Congenital pyloric stenosis (10) 1.95% Teratoma (9) 1.75% Wilm´s tumor (8) 1.56% Congenital megacolon (7) 1. 36% Traceoesophageal fistula (3) 0.58 Common bile duct atresia (3) 0.58% Otherdisease (82) 15.9890
2. Among 513 cases, the latest number of cases are below 3 years of age (143. 1%) the ratio of male to female is 1.8 1. with seasonal variation, spring and summer groups are in largest number.
3. In the appendicitis, the largest numbers of cases are from 13 to 15 years of age (50.5%) the ratio of male to female to female is 1.9:1. The ratio of perforation was 72% in the group, from 4 to 6 years of age. The ratio of complication in perforation group is 50% in non-perforation.
4. In the hernia in the group below 1 year of age, the cases are 29 (35.4%) and in the group 3 years of age, 50 (60. 9%).The lager in age, the smaller in cases. (in the group from 4 to 6 years of age 16 (19.5%) and from 7 to 9 years of age 8 (9.8%) The ratio of male to female is 5.3: 1. The cases in incarceration is 16 (20%) and with strangulation among the incarceration cases was 2 (12.5%)
5. In the Intussusception, the largest number of cases are from 4 to 6 years of age (12. 7%) the rate of male to female is 1 7: 1 seasonal variation is not noted. Ileocecal type was the most common and accounted for approximately 75% of all cases (47 cases). The next common type was coloclic & accounted for approximately 10% (6 cases). Among all 63 cases, 50 cases was performed barium enema reduction 35, cases of those 50 cases was reduced completely and was seen barium refluxing through the ileocecal valve into the ileum 28 cases of those 50 cases underwent operative reduction. It was found that the longer interval between the onset and performance of the barium enema, the more difficult in reduction. Among 14 cases, whose intussuception has been present for over 48 hours when the patient is first seen, 13 cases has been failed in redution. Among those 28 cases, 25 cases was reducted by simple operative reduction, and remaining 3 cases was done resection with primary anastomosis. Recurrence was observed in 2 cases.
6. Among 66 cases of observed burn patients, the 55. 7% of those cases occurred in the first 3 years of life, 16 cases (or 26.2%) between 4 & 6 year, an 11 cases (18. 1%) between 7 & 15 year of age, The sex ratio was 1.1: 1, male to female. The injuries most frequently occurred during springtime. By the total area of burn injury, extent less than .10% observed most frequently & accounted for 25 cases (or 41%), and 12 cases over 40%. The third degree burn was seen slightly more than _second degree. 26 cases (42.6%) was third and 24 case (39.4%) of second degree. Head was most commonly involved site and accounted for 78.8% (48 cases). The perineum was next in order and applied in 59. 0% & least commonly the trunk which observed in 23 cases (37. 7%).
7. The imperforated anus was usually detached before first 24 hours of life, as much as in 10 cases (or 45%). Male preponderance over female by 1.9: 1 was noticed. Type 3 was most frequently seen and accounted for 77. 5% (31 cases). The most commonly associated fistulous tract. was the perineorectal fistula in male which has been observed,-in 8 cases, and in female, 12 cases (66.7%) of rectovaginal fistula.
8. Congenital hypertorophic pyloric stenosis was diagnosed between 3rd and 4th weeks of life in 6 cases (or 66%) 2 cases (20%) was seen between 4th and 5th weeks of life, 8 cases of those 10 cases were performed F-R pyloromyotomy. The lnfeetion was complicated only in I case (10%).
9. Wilm´s tumor most commonly found at age between 2 and 4 year old. In 6 cases, chief complaints were palpable abdominal mass and distended abdomen. Hypertension was observed in 3 cases in 3 cases. The metastasis to contigious regional lymph node was seen in 3 cases ´with to lung in one case.
10. The congeintal megacolon was usually diagnosed immediately after birth. In over series 5 cases (71.4%) was detected within first 24 hours of life. Male prepondernce over female by 2.5: 1 was. obtained Various operative procedure was employed, 4 cases was performed Soav´s procedure, 2 cases (28.6%) with Duhamel´s procedure- and one case (4%) with sigmoid colostomy. Of those, 2 cases was died.
11. Various types of accidents were most frequently seen at age between 7 & 9 year old and 39.6% (19 cases) belonged to that age group, 13 cases, at age between 10 & 12 year-old was noted -and least common between, 4 & 6 year-old. The sex ratio was 1.3 : 1, male to female. No seasonal difference in occurrence of the accidents was recognizable.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|