<原著>特発性S状結腸穿孔 : 本邦報告63例についての考察

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Idiopathic perforation of the normal colon is a rare disease. Although idiopathic perforation of the sigmoid colon is most frequent, only 63 cases have been reported in the literature in Japan from 1942. This perforation should be differentiated from the stercoral perforation by microscopic findings. In Japan, ages ranged from 16 to 87 years, the ratio of males to females was 1.7 : 1,males in the sixth decade and females in the sixth and seventh decades were most common. The overall mortality was 39 per cent, which resulted from septicemic shock, especially from endotoxin shock. A 42-year-old female complaining of severe abdominal pain associated with marked acidosis and leukocytopenia underwent celiotomy. The antimesenteric border of middle simoid had perforated, developping extensive stercoral peritonitis. The patient was treated with closure of the perforated site. Macroscopic and histologic examinations and postoperative barium enema revealed no original disease responsible for the perforation. Intravenous administration of Dopamine hydrochloride (Inovan^<[○!R]>) was effective to relieve her immediate postoperative condition, which was presumably caused by endotoxin shock. The preoperative diagnosis of idiopathic perforation of the sigmoid colon is impossible except for a few insidious cases. Early operative intervention and administration of antibiotics and anti-shock agents are indispensable for resuscitation of patients. Dopamine hydrochloride may be one of the effective agents against a serious shock developping in the course of peritonitis.
近畿大学の論文
1979-09-25

<原著>特発性S状結腸穿孔 : 本邦報告63例についての考察

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