CLINICAL STUDIES ON 35 CASES OF PERFORATION OF THE SMALL BOWEL

Abstract

During the last 10 years, 35 cases of perforation of the small bowel were treated. 16 cases (45.7%) were due to post operative adhesive ileus, 10 (28.6%) to abdominal trauma and 4 (11.4%) to inguinal or femoral hernia. Operative mortality was 17.1%. Thirty-six hours after operation, mortality was 4.3%, but over 36 hours mortality was elevated to 41.7%. In cases of small bowel perforation due to abdominal trauma and hernia, operations were undertaken sooner than in cases of perforation, due to adhesive ileus. In these cases, prognosis was good. On the other hand, all cases of small bowel perforation due to malignant tumor and mesentery arterial thrombosis died within 30 days of operation; thus the prognosis of these cases was extremely poor. Abdominal free air, leucocytosis (over 10, 000) and muscular defense were decisive factors in undertaking operation. Leucocytosis was found in 51.4% of all cases, and abdominal free air in only 34.3%. On the other hand, muscular defense was found in 85.7%, so that it was necessary to observe the patient's condition, espcially abdominal signs, carefully.