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KMID : 0371319840270010071
Journal of the Korean Surgical Society
1984 Volume.27 No. 1 p.71 ~ p.79
A Clinical Analysis of 104 Cases of Small Bowel Perforation




Abstract
This report is an analysis and review of 104 cases of small bowel perforation treated at the Department of Surgery, Chosun University Hospital during 6 years from January 1977 to December 1982.
The following results were obtained.
1) The main etiologic causes were blunt abdominal trauma(46.1%) and typhoid ulcer perforation (29. 8%).
2) The most prevalent age group was 21 to 30 years(31.7%).
3) Among 104 cases, there were 80 males(77%) and 24 females(23%), and male to female ratio was 3.3 : 1.
4) The common clinical symptoms and signs were abdominal pain(94.2%), abdominal tenderness (87.5%), rebound tenderness (60.0%), abdominal rigidity(51.9%) and abdominal distension (50.0%).
5) In abdominal simple X-ray finding, subphrenic free air was found in 56.6%, peritoneal irritation sign and paralytic ileus in 84.7%.
6) In hematologic finding, 61 cases(58.6%) showed leukocytic change, 16 cases(15.4%) showed leukopenic change.
7) 75 cases(72.1%) visited our hospital with in 24 hours after perforation but 15 cases (14.4%) over 48 hours.
8) The site of perforation due to typhoid ulcer was noted within 100 cm proximal to ileo-cecal junction in 100%, site of perforation due to blunt abdominal trauma over 200cm pro-ximal to ileocecal junction in 54.2%.
9) In the size of perforation, 75 cases(72.1%) showed below 1.0 cm in diameter.
10) In the number pf perforation, single number of perforation was 68 cases(65.4%).
11) As for the operative procedure, 62 cases(59.6%) were treated by primary closure with
debridment, 42 cases(40.4%) by segmental resection & end to end anastomosis.
12) The incidence of postoperative complication was 34.6% and wound infection & disorption was the most common complication (27.9%).
13) The overall mortality rate was 14.4% and sepsis was the most common cause of death (53.3%).
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