[原著］大腸穿孔症例の臨床的検討 : 特に術前における重症度の推定国子について

概要

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Colorectal perforation may cause serious fecal peritonitis at an early stage due to fecal leakage and may result in septic shock leading to disseminated intravascular coagulation (DIC) or multiple organ failure (MOF). In this study, we retrospectively investigated cases of colorectal perforation and analyzed factors influencing prognosis. The subjects were 33 patients treated at our department over 13 years; from January 1988 to March 2000. Patients with appendicular perforation were excluded. There were 22 men and 11 women with a mean age of 50.8 years. The underlying causes of colorectal perforation were colorectal cancer in 14 patients, idiopathic in 5 patients, diverticula of the colon in 5 patients, trauma in 4 patients, iatrogenic in 3 patients, colonic ulcer in 1 patient, and Crohn's disease in 1 patient. Nine patients died following surgery, including 5 patients with colorectal cancer, 2 with idiopathic, 1 with trauma, and 1 patient with colonic ulcer. The death rate after surgery was 27.3%. In regards to decisive factors of prognosis, patients who had shock symptoms, acidosis and abdominal free air before surgery showed a significantly poor prognosis.
琉球医学会,Ryukyu Medical Associationの論文