[原著］小腸穿孔33例の臨床的検討

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We reviewed our surgical treatments for perforation of the small intestine in thirtythree cases (28 male, 5 female; mean age, 40.4 years old) over the past 15 years. The causes of the perforation were traumatic in seventeen patients and non-traumatic in sixteen patients. A large number of the traumatic cases were caused by stab wounds, while most of the non-traumatic cases were due to intestinal obstruction. The mam clinical symptoms that the patients presented with were abdominal pain (30 patients), vomiting (6 patients) and hypovolemic shock (6 patients). Computed tomography or plain roentgenogram detected intra-abdominal free air only in 36.4 % of the cases. Emergency operations were carried out based on the diagnosis of localized or generalized peritonitis, and small intestinal perforation was confirmed intraoperatively. Two different surgical procedures were carried out: simple closure in 10 patients, and partial resection of the perforated site with primary anastomosis in 23 patients. The usual sites of perforation were the jejunum in the traumatic and the ileum in the non-traumatic cases. The most common postoperative complication was wound infection. In the non-traumatic cases, it took a longer time from the onset to the operation as compared to the traumatic cases. Postoperative death occurred in eight patients(traumatic: 2 patients, non-traumatic: 6 patients) and preoperative deterioration such as hypovolemic shock indicated poor prognosis. Preoperative diagnosis of small intestinal perforation is difficult despite the usage of recent imaging modalities. Accurate diagnosis and prompt surgical procedure is mandatory for the treatment of small intestinal perforation.
琉球医学会,Ryukyu Medical Associationの論文

[原著］小腸穿孔33例の臨床的検討

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