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KMID : 0371319920430050670
Journal of the Korean Surgical Society
1992 Volume.43 No. 5 p.670 ~ p.677
A Clinical Study on Peptic Ulcer Perforation


Abstract
This article consists of a clinical study of 72 cases of perforated peptic ulcer who were treated at the department of General Surgery in the Pusan Adventist Hospital from August. 1986. To July, 1991.
@ES The results were as follows:
@EN 1) Among there 72 cases, the perforated gastric ulcers were 7 cases(9.7%) and perforated duodenal ulcers were in 65 cases(90.3%).
2) In age distribution, the highest incidence was 3th decade, and 4th decade was followed.
3) The sex distribution was 67 cases in male and 5 cases in female with ratio of 13.4 : 1.
4) The seasonal variation was highest in February(16.7%), and July(9.7%) was followed.
5) The duration of the symptom of peptic ulcer prior to perforation was most common for 5~10 years by 16 cases(22.2%), but 11 cases(15.3%) had no previous ulcer symptom.
6) By the physical finding on admission, the majority of the cases had abdominal tenderness (98.6%), decreased bowel sound(95.8%), abdominal rigidity(94.4%).
7) Among the 4 types of blood groups. O type was relatively common than others.
8) The subdiaphragmatic free air shadow was seen in 51 cases(70.8%).
9) In subdiaphragmatic free air shadow was not seen(21 cases). after injected air(500 cc) with Levin tube, than subdiaphragmatic free air shadow was seen in 19 cases(90.5%).
10) The preoperative duration after perforation was from 12 hours to 24 hours in 29 cases (40.3%) and from 6 hours to 12 hours was followed(38.9%).
11) The size of perforated orifices was from 0 mm to 5 mm in diameter with 64 cases(88.9%).
12) In method of operation: Truncal vagotomy with pyloroplasty was performed in 42 cases (58.3%). Subtotal gastrectomy was 17 cases(23.6%), Simple closure was 11 cases(15.3%). Truncal vagotomy with antrectomy was 2 cases(2.7%).
13) During the early postoperative complication, wound infection was the commonest(5 cases, 6.9%).
14) Postoperative mortality rate was 5.5%(4 cases). But the patients were very poor preoperative condition.
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