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KMID : 0438219740110010555
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Korea University Medical Journal
1974 Volume.11 No. 1 p.555 ~ p.564
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Clinical Analysis of Gastroduodenal Ulcer Perforation
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Abstract
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Perforation may complicate gastroduodenal ulcer and it may be miner and close within a short time, but it is generally major with a potentially the most lethal complication of gastroduodenal ulcer. The following is an analysis of patients who were treated surgically for their gastroduodenal ulcer perforations collected at the Dpt. of General Surgery, Woo Sok Hospital, Korea University College of Medicine during a period from January 1970 to June 1973.
1. Among the 74 cases of gastroduodenal ulcer perforations, duodenal perforation was in 42 cases (56.6%), and gastric perforation was in 32 cases (43.24%), and the ratio between duodenum to stomach was 1.3:1.
2. The most liable age bracket was 3rd and 4th decades occupying 38.64% of all gastroduodenal perforations.
3. Male patients were 63 caries (85.1%), and female 11(14.8%) and the ratio was 5.7:1 for male. 4 Most prevalent month of the year was June (13 cases, 16.56%), followed by January, April, September and December (3 cases, 3.24´%) in decreasing order of frequency.
5. The period from initiation of symptoms to the time of perforation was 1 to 3 years in 22 cases (29.71%).
6. All cases represented epigastric pain and abdominal rigidity was noted in 66 cases (89.18%) at the time of admission.
7. 58 cases (78.16%) revealed intraperitoneal free air on simple abdominal X-ray film at the time of initial examination.
8. C. B. C. at the time of admission revealed normal in 58% of cases.
9. The period from acute perforation to the time of operation was 6 hours in 48 cases (64.86%).
10. Perforations were noted in 26 cases (81.25%) of: 32 cases of gastric ulcer perforations within 3cm. from the pyloric ring. Thirty cases(83.33%) out of 42 of duodenal ulcer perforations were noted within 1cm. from pyloric ring at the anterior wall:
11. Majority of cases (51 cases, 68.91%) represented the size of perforation within 5mm., and 6 cases .(8.10%) were over 10mm. in diameter.
12. In the method of treament, 41 cases(55.4%) received simple closure, 4 cases(5.41%) with
subtotal gastrectomy, and 29 cases (39.19%) treated with vagectomy and pyloroplasty.
13. Postoperative courses were uneventful except 29 cases(39.1%) who revealed postoperative com-
plications inclucing 16 cases(21.6%) of wound infections.
14. Postoperative results were excellent in 40 cases(53.97%) including 17 cases of simple closure (22.9%), 3 cases(4. 05%) of subtotal gastrectomy, and 20 cases(27. 03%) of vagectomy plus pyloroplasty. Poor results were noted in 1 case of sutotal gastrectomy and 7 cases of simple closure.
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