수술적 처치를 요한 염증성 장질환
Inflammatory Bowel Disease Requiring Operative Treatment
정병욱, 김형록, 김동의, 김영진, 김신곤,
소속 상세정보
정병욱 ( Jung Byung-Wook )
전남대학교 의과대학 외과학교실
김형록 ( Kim Hyeong-Rok )
전남대학교 의과대학 외과학교실 위장관외과
김동의 ( Kim Dong-YI )
전남대학교 의과대학 외과학교실 위장관외과
김영진 ( Kim Young-Jin )
전남대학교 의과대학 외과학교실 위장관외과
김신곤 ( Kim Shin-Gon )
전남대학교 의과대학 외과학교실 위장관외과
KMID : 0356719980140030531
Abstract
Twelve patients with inflammatory bowel disease had been operated at the department of surgery, Chonnam University Hospital during the period from March 1988 to February 1997. In this study, we report on the operative cases regarding age, sex, symptoms, duration of disease, location of disease, preoperative diagnosis, operative indication, frequency of operation, histopathologic findings and follow up. The results were as follows: 1) The male to female ratio in ulcerative colitis was 1 : 1, and the mean age was 54.5 years. In Crohn’s disease, male to female ratio was 2.3 : 1 and the mean age was 42.1 years. 2) The mean duration of symptoms in ulcerative colitis was 39 months and in Crohn’s disease was 13.9 months. The common symptoms in ulcerative colitis were abdominal pain, bloody diarrhea, indigestion, weight loss and in Crohn’s disease abdominal pain, palpable mass, weight loss, indigestion. Extraintestinal symptoms in Crohn’s disease were cholelithiasis like symptom, anal fistula, anal fissure. 3) The involvement site in ulcerative colitis was large bowel only, but in Crohn’s disease small bowel (50%), large bowel (20%), small and large bowel (30%) were involved. 4) Preoperative diagnosis in ulcerative colitis was accurate, but in Crohn’s disease accurate diagnosis was made only in 20% and the other cases were operated under the impression of different diseases or conditions (intestinal tuberculosis (50%), bowel perforation (20%), mechanical ileus (10%)). 5) The indication of surgery in ulcerative colitis was intractability to medical treatment, on the other hand, in Crohn’s disease most operative cases were made under the emergentconditions (bowel perforation, bowel obstruction, enterocutaneous fistula, abdominal mass). The
frequency of operation in ulcerative colitis were two times in one case, three times in one cases. In Crohn’s disease half of cases experienced two or three times of surgery. The method of operation in ulcerative colitis was total proctocolectomy with J-pouch ileoanal anastomosis. In Crohn’s disease resection of diseased bowel segment was performed.
키워드
Inflammatory bowel disease;Ulcerative colitis;Crohn’s disease
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