A clinical review was made on 541 cases of perforated G-I tract which were treated at the department of surgery of Kangnam General Hospital from May 1976 until Oct. 1983.
The results were as follows.
1) Among 541 cases, 96 cases(17.74%) were stomach performation due to peptic ulcer (80.35%), cancer(15.62) and trauma(1.04%), 158 cases(29.20%) were duodenal perforation due to peptic ulcer(97.46%), 158 cases(29.20%) were duodenal perforation due to peptic. ulcer(97.46%) and trauma(2.53), 203 cases were peforated appendicitis(37.70%), 77 cases. (14.23%) were small-bowel perforation due to tauma(59.74%) and typhoid fever(35.06), 7 cases(1.29%) were large bowel perforation due to cancer(41.85%), trauma(28.07%) and strangurated obstruction(28.56%). According to the causes of G-I perforation, peptic-ulcer was the. most common cause, involving 234 cases(43.25%), followed by perforated appendicitis(37.7O%), trauma(9.79%), typhoid fever(4.99%), cancer(3.32%) and strangurated ob-strution(O.36%).
2) The over all sex-ratio of male to female was 3.03:1 and according to the cause of G-l perforation, the ratio was 4.3:1 in gastric perforation, 14.8:1 in duodenal perforation. 1.4:1 in perforated appendicitis, 2.7:1 in small-bowel perforation and 6:1 in large-boweL perforation.
3) The over all peak incidence of age was the 2nd decade and for the individual disease,. the 4th decade in gastric perforation, the 2nd decade in small bowel perforation, the 1st decade in perforated appendicitis, both the 1st and 3rd decade in large-bowel perforation.
4) The seasonal distribution of incidence was not significant.
5) The chief clinical manifestation were abdominal pain(95.7%), tenderness(91.3%) and rebound tenderness(86.9%).
6) The subdiaphragmatic free-gas were seen in 283 cases(52.31%) and for the individual disease, 91 cases(94.79%) in stomch perforation, 145 cases(9l.77%) in duodenal perforation, 40 cases(51.94%) in small-bowel perforation, 5 cases(71.42%) in large-bowel perforation and 2 cases(0.98%) in perforated appendicitis.
7) The duration from perforation to operation over 24 hours were 313 cases(57.85%).
8) The over all incidence of postoperative complication was 35.1% and for the individual disease, 24.0% in stomach perforation, 20.03% in duodenal perforation, 43.3% in perforated appendicitis, 53.2% in small-bowel perforation and 85.7% in large-bowel perforation. The most common complication was wound infection(19.0%).
9) The over all mortality rate was 4.99% and for the individual disease, 6.25% in stomach perforation, 5.06% in duodenal perforation, 0.98% in perforated appendicitis, 10.38% in small bowel perforation and 42.85% in large-bowel perforation.
10) The main causes of death were sepsis(40.7%) and acute renal failure(ll.1%)
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