A clinical investigation of thirty-four cases of bile peritonitis, who were treated at the Department of Surgery, Chonnam University Hospital during 5 years, from Jan., 1977 to Dec., 1982 was performed.
After clinical review, following results were obtained.
1) The sex distribution was 20 males (59%) and 14 females (41%), and 5th decade (35%) showed the highest incidence.
2) The spontaneous perforation of the gallbladder in acute cholecystitis was the most common cause of the bile peritonitis in 17 cases (50%).
3) Six cases (18%) had a past history of chronic cholecystitis and it was the most frequent past history of bile peritonitis.
4) Preoperative diagnosis was correct 61% (21 cases) and duration of illness was usually less than 2 weeks (58%).
5) The most common symtom and sign was R.U.Q. pain and abdominal tenderness respectively.
6) There revealed almost no anemic sign but mild leukocytosis was noted in 16 cases (47 %) and elevated serum bilirubin in 19 cases (56%) and elevated alkaline phosphatase in 15 cases (44%),
7) If the patient´s conditions were permitted. We performed definitive surgery of the primary disease in biliary tract, and if not, performed drainage of the leaked bile.
8) Postoperative complications were noted in 36% and the most common complication was wound infection in 5 cases (15%).
9) The mortality rate was 12% (4 cases), and it was supposed to decrease mortality rate by early diagnosis and operation and massive antibiotics with fluid and electrolyte therapy.
|