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KMID : 0376419770010000051
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Chonbuk University Medical Journal
1977 Volume.1 No. 0 p.51 ~ p.58
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Clinical Review and Analysis of Perforated Typhoid Ulcers
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Abstract
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Clinical observation was made of 42 cases of patients who were operated with perforation of the ileum secondary to typhoid fever, which were experienced from February, 1972 to August, 1976 at the Department of Surgery, jeonbug National University Hospital.
The results were as follows, :
1. Ileal perporation due to typhoid fever was occured most frequently in those between the age of 2029 years and the male-female ratio was 2, 8 : 1.
2. Perforation was developed most frequently over 2 weeks after onset.
3. Most of the patients complained of fever, abdominal pain, chills, nausea and vomiting in order of frequency.
4. Common physical findings were abdominal tenderness, rebound tenderness, rigidity and distention in order of frequency.
5. In the hematologic fiding on admission, the leukopenic changes(below 6, 000/xx3) was in 45.2%.
6. The result of the widal test was positive in 71.8 % (above 1 : 160 in 0 titers)
7. The Xray studies revealed the subdiaphragmatic; free gas in 54.89/6 and the paralytic ileus in 92.9% of the perforated cases.
8. In Operative findings, over 85 % of the perforations occured within 60 cm. proximal to the ileocecal valve, and the number of the perforation was single in 32 Sases(76.2%) and multiple in 10 cases (23.8 %).
9. Four types of operative methods were used, those were segmental resection with end-toend anastomosis in 27 cases (64.3 %) , simple closure in 8 cases (19 %) , ileostomy in 6 cases (14.3 %) and abdominal drainage only in 1 case (2.4 %).
10. Complications after surgery were wound infections(35.7%), septicemia (16. 7 %), wound disruption (14. 3 %), adhesion(9.5%), intestinal fistula(7.1%), intraabdominal abscess (4.8%), bleeding (2.4 %) and disruption of the anastorrilosis (2.4 %).
11. The overall mortality rate was 16.7%.
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