We had managed 85 cases of the nontraumatic small intestinal perforations during the 10 year period from 1976 through 1985 at the Department of Surgery, Kyungpook National University Hospital.
There were 64 cases of typhoid fever, 8 cases of tuberculous enteritis, 5 cases of intestinal obstruction, and one case of mesothelioma as the underlying cause of the small intestinal perforation.
The correct preoperative diagnosis of the underlying cause was established in 93.8% of typhoid fever, 60% of intestinal obstruction, and 37.5% of tuberculous enteritis.
Of the patients with the typhoid fever, the highest positive rate of the Widal reaction was reported in the fourth week of the disease, and the blood culture for Salmonella typhi in the second week of the disease.
The morbidity of the patients with intestinal obstruction was 80%, typhoid fever 48.4%, tuberculous enteritis 12.5%.
The morbidity was 31.4% in patients with minimal peritoneal contamination, 54.8% with moderate contamination, 63.2% with severe contamination. This difference was statistically significant.
The morbidity according to the types of the operation was not significantly different.
|