A clinical review and study were made of patients 181, with a diagnosis of gastroduodenal perforation treated at the department of general surgery, hospital of college of medicine, Chungnam National University between January, 1976 and December 31, 1982 the results were as follow:
1) Causative disease were duodenal ulcer in 120 cases (66.3%), stomach ulcer in 43 cases (23.7%), stomach cancer in 5 cases (2.8%), stomach injury in 7 cases (3.9%), duodenal injury in 5 cases(2.8%), gastroduodenal injury in 1 case(0.5%).
2) The highest age incidence was fifth decade, in 42 cases (23.21%) and followed by fourth decade, in 38 cases (21.0%) and the sex incidence were 168 male and 13 female subjects, a ratio of 13:1
3) Among 168 cases of peptic ulcer and stomach cancer 53 cases (31.510) were asymptomatic for hunger pain, 30 cases (17.9%) were within one year history of hunger pain and 85 cases (50. 6%) were over one year history hunger pain.
4) Prior to perforation 132 cases (73%) underwent the operation within 24 hours for perforation and 49 cases (27%)after 24 hours.
5) The remarkable finding on admission were epigastric pain in 176 cases(97.2%), abdominal rigidity in 157 cases (86.7%), rebound pain 156 cases (86.2%) which were peritoneal irritation sign, finding of peritonitis.
6) W. B. C count revealed over 10.000/mm3 in 109 cases, 60.2% and below 10,000/mm3 in 72 cases, 39.8%.
7) Intraabdominal free air was seen in 151 cases 83.4% on x ray examination
8) The operative procedures were as follow: subtotal gastrectomy in 77 cases, 42. 5%, simple
cloure in 39 cases, 21.6%, truncal vagotomy with antrectomy in 36 cases, 19.9% truncal vagotomy with pyloroplasty in 27 cases, 14.9%, parietal cell vagotomy in one case 0.5%.
It seems that subtotal gastrectomy is still the preferred method of treatment for gastric ulcer in this country and truncal vagotomy with antrectomy or pyloroplasty are treatment of choice for duodenal ulcer.
9) 35 patients, 18.2% in this series developed to early postoperative complications those were wound infection, in 21 cases, 12.5%, leakage of anastomotic site or duodenal stump, intestinal obstruction and pulmonary complication etc.
10) The over all mortality was in 6 cases 3.3% and the cause of death were sepsis in 3 cases, liver failure in 2 cases and pulmonary distress in one case.
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