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KMID : 0352119890050030266
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Journal of Kyung Hee University
1989 Volume.5 No. 3 p.266 ~ p.274
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A CLINICAL ANALGSIS OF RISK FACTORS IN PERFORATED DUODENAL ULCER
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Abstract
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A clinical analysis on 169 patients with doudenal ulcer perforation who were admitted to the Department of General Surgery, Kyung hee University Hospital from April 1979 to march 1988 was done and summarized as ollows.
1) The male to female sex ratio was 20.1:1.
2) 108 cases (63.9%) of patients had a history of ulcer Ymptom over 3 months. But 27 cases (16.0%) had no lrevious ulcer symptom.
3) Chest and plain abdominal films revealed subdia-
i)hragmatic free air shadow in 151 cases (89.3%).
4) majority (79.8%) was within 24 hours in time inter-,al between perforation and operation.
5) Liver cirrhosis was commonly associated disease ´2.4%) and next were pulmonary tuberculosis (1.8%), ,:ongestive heart failure (1.8%) and cerebrovascular ~(Ccident (1.8%).
6) Operation procedure were lrunCal vagotomy and :Intrectomy in 107 cases (63.3%), truncal vagotomy and drainage in 28 cases (16.6%), primary closure in 25 cases
(14.8%), subtotal gastrectomy in 7 cases (4.1%) and highly selective vagotomy and primary closure in 2 cases (1.2%).
7) Shock on admission, severe medical illness, long-standing perforation (more than 24 hours) and severe peritoneal contamination were the stastistically significant risk factors that increased mortality in our cases.
8) The morthality rate was increased with increment of number of risk factors; 0%, 9.1%, 54.5% and 100% in patients with one, two, three and all four risk factors.
9) The postoperative complications were noted in 40 cases and the commonest complication was wound infection in 20 cases.
10) The postoperative mortality rate was 7.1%.
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KEYWORD
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