Diagnosis and treatment of digestive tract perforation in 85 cases

Abstract

Objective To investigate the best way of diagnosing and treating the digestive tract perforation.Methods Clinical pathological and follow-up information of patients in Anze county people' s hospital from January 2006 to December 2011 were collected.Statistical analysis was conducted using the SPSS 17.0 software.Results All 85 patients were received operations.The main symptoms for medical in the first time:intense abdominal pain,tenderness,and rebound teneer-ness 58 cases (68.2％).Nausea and vomiting with anemia or bloody stool in 15 cases (17.6％),shock in 9 cases (10.6％),fever in 3 cases(3.5％).Three-dimensional abdominal plain X-ray with free air occured in 68 cases.Duodenal ulcer perforation in 23 cases (27 ％),gastric ulcer perforation in 57 cases (67 ％),gastric cancer perforation in 5 cases(5.9％)after postoperative pathology.The patients who received gastroduodenal perforation repair or ulcer resection were 58 cases (68.2％),who received subtotal gastrectomy were 23 cases(27.1％),who received radical surgery for gastric cancer were 4 cases(4.7％).Postoperative ulcer recurrence rate:perforation repair or ulcer resection with 15 cases(26.8％),2 cases died,subtotal gastrectomy with 4 cases(14.8％),1 cases died.The recurrence rate had statistical significance between two groups (x2 =4.078,P ＜ 0.05).Conclusions The main symptoms of upper digestive tract perforation patients are,tenderness,and rebound tender-nsee.Shock signs occurs in the 24 hours later after perforation.X-ray with free air should be concerned.The simple perforation repair or ulcer excision repair Combined with acia inhibitory drugs can decrease the recurrence rate,subtotal gastrectomy is the radical therapy. Key words: Peptic ulcer; Acute perforation; Diagnosis ; Surgical treatment