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KMID : 0378019670100080047
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New Medical Journal
1967 Volume.10 No. 8 p.47 ~ p.54
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Roentgenological Observations in Acute Abdomen
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申勝雨/Shin, Sung Woo
金鎭國/金炳洙/Kim, Chin Kuk/Kim, Byung Soo
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Abstract
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80 patients diagnosed as having acute abdomen have been studied from the roentgenological and clinical points of view. 75 of the patients were operated upon and 14 were not.
X-rays taken in the simple erect position were divided into four groups according to the patterns of bowel gases and fluid levels shown. Cases with typical spring-coiled appearances were classified as group 1, cases with sun-ray patterns as group 2 and cases with´ appearances of fluid levels without plica circularis or haustral mar-kings as group 3. Cases showing irregular gas patterns in the bowel were classified as group 4.
Operative findings were of two types, the simple type in which disease was localized in the intestine, and the complex type in which both the intestine and the adjoining tissues were involved.
The following results were obtained :
1. The sex incidence was about 2:1, males predominating, (59 male : 30 female). The greatest number of patients were between 21 and 40 years of age, 17 being between 31 and 40 }rears and 14 being 21 and 30 years.
2. 44 patients (57/) of those receiving operative treatment reached the hospital within 24 hours of the onset of symptoms: 11 patients (75%) of those who were not operated on arrived at the hospital later than 24 hours after the first symptoms had begun.
3. The majority of patients operated upon, were found to have perforation of the bowel(64%) 19 of these (40%), being due to typhoid fever. The next most common finding at operation was intestinal obstruction in 22 patients (29%): intussusception was the cause of obstruction in 8 (36%), of these cases.
4. X-rays taken in the simple, erect position of the 48 cases of perforation of bowel, showed free gas in 31 (64.2%). Among these cases two were roentgenologically normal, 5 cases were placed in group 1, 12 cases in group 2 and 12 ir, group 3.
5. X-rays taken in the simple erect position on 19 patients found to have intestinal obstruction, showed one case to have normal bowel patterns, while 8 cases were placed in group 1, 6 case sin group 2 and 7 cases in group 3.
6. The relationship betv,,een the x-ray appearances of the bowel, and the intra-abdominal findings at operation was as follov,,s: 9 cases (75%) of simple type were placed in group 1, and 21 cases (33%) of complex type were placed in group 2; 28 complex cases (44%) were placed in group 3.
Of the patients who did not have surgry, 6 cases (43%) were placed in group 1 and other 6 cases (43%) were placed in group 4.
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