|
KMID : 0378019790220030035
|
|
New Medical Journal
1979 Volume.22 No. 3 p.35 ~ p.39
|
|
|
Clinical Experience of Typhoid Ulcer Bleeding
|
|
|
|
|
Abstract
|
|
|
Although it has been known that typhoid fever is a curable infectious disease still it has relatively high mortalily and severe toxic effect which so often results in complications requiring surgery.
Massive intestinal bleeding is one of the most serious complications with high mortality and even though bleeding is controlled by surgery, it remains many problems due to deterioration of homeostasis by multiple transfusions and longstanding preoperative nutritional deficiency.
On laparatomy in the severe case, a surgeon sometimes cannot be decide where to resect the bowel because of obsecuring gross pathology by its contents of dark blood clot.
Fortunately the most of all ulcer usually located at Payer´s patch of-terminal ileum which is easily identified, but it can be possibly located in the colon which could, not be confirmed by external examination´ only. So blind resection of terminal ileum only may cause recurrent bleeding which has a fatal outcome.
Recently author have experienced 4 operative cases of severe typhoid ulcer bleeding. Three of them showed recurrent bleeding; one generalized oozing, reop and death due to sepsis, the other one recurrent melena, reop(O & C), death, the other one, recurrent melena, reop (Rt..colectomy), enterocutaneous fistula (grave now).
With the above experience, author try to review of each case history and adopt that bleeding lesion should be widely resected by confirming the oppenned inner surface of the distal ileum proximally and ascending colon distally from the ileocecal Junction in order to prevent fatal recurrent bleeding.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|