This report is a clinical review of 207 cases of peptic ulcer perforation that had been treated for 5 years from Jan. 1988 to Dec. 192 at the department of General surgery, college of medicine, Hallym university.
@ES The results was as follows:
@EN 1) Among these 207 cases, the perforated duodenal ulcer were 164 cases(79.2%) and the peforated gastric ulcer were 43 cases(20.8%) with the ratio of 4 : 1.
2) The peak age incidence was 4th decade in duodenal ulcer(29.9%) ad 7th decade in gastric ulcer923.3%)
3) In sex distribution, 195 cases were male(94.2%) and 12 cases(5.8%) with the ratio of 16.3 : 1.
In perforated duodenal ulcer, the ratio was 81.8 : 1 and perforated gastric ulcer, the ratio was 5.1 : 1.
4) The monthly distribution was prominent on June.(11.6%) & Nov.(11.6%) ad Aug. showed the least incidence(2.9%).
5) Among the types of blood groups. 0 type was relatively common then others.
6) Thd duration of past history prior to perforation was most common for over 3 years with 62 cases(29.9%), but 44 cases(21.3%) had ho previous ulcer symptoms.
7) The physical findings on admission were abdominal tenderness(97.1%), abdominal rigidity (93.7%), decreased bowel sound(92.3%) and abdominal rebound tenderness(83.1%).
8) In radiologic study, subdiaphragmatic free air shadow was positive I 166 cases(80.2%).
9) In laboratory finding: Anemia(3.4%), hemoconcentration(54.1%), leukocytosis(79.7%) and increased serum amylase level(9.2%).
10) The associated disease were observed in 21.7% of cases and were liver cirrhosis, hepatitis and pulmonary tuberculosis in descending order of frequency.
11) In method of operations: simple closure was performed in 47 cases(22.7%), truncal vagotomy with pyloroplasty was 106 cases(51.2%), truncal vagotomy with antrectomy was 26 cases (12.6%), subtotal gastrectomy was 28 cases(13.5%).
12) The early complications(22.2%) were as follows: pulmonary complication was the most common with 16 cases(7.7%), ileus with 10 cases(4.8%) and wound infection with 4 cases(1.9%).
13) The delay complications were as follows: simple closure, ulcer recurrence in 7 cases(14.9%).
In truncal vagotomy with pyloroplasty, intractable diarrhea in 16 cases(15.1%), ulcer recurrence in 4 cases(3.8%).
In truncal vagotomy with antrectomy, diarrhea in 2 cases(7.7%), alkaline reflux gastritis in 1 cases(3.8%), dumping syndrome in 2 cases(18.2%).
In subtotal gastrectomy, diarrhea in 4 cases(14.3%), alkaline reflux gastritis in 3 cases(10.7%), ulcer recurrence in 2 cases(7.1%), dumping syndrome in 3 cases(10.7%), anemia in 2 cases(7.1%).
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