숙변성 천공의 임상적 고찰
Clinical Analysis of Stercoral Perforation of Colon
정철웅, 홍정훈, 민병욱, 문홍영,
소속 상세정보
정철웅 ( Jung Chul-Woong )
고려대학교 의과대학 외과학교실
홍정훈 ( Hong Jeong-Hun )
고려대학교 의과대학 외과학교실
민병욱 ( Min Byung-Wook )
고려대학교 의과대학 외과학교실
문홍영 ( Moon Hong-Young )
고려대학교 의과대학 외과학교실
KMID : 0356720020180040229
Abstract
Purpose: Stercoral perforation of colon is a rare disease with poor prognosis. But according to recent reports, the incidence of stercoral perforation in the colon seemed to have been underestimated. The reason might be the lack of
recognition and overlook by surgeons. The purposes of this study were to represent the definition of stercoral perforation, and to help the diagnosis and treatment of stercoral perforation.
Methods: Among the patients who underwent emergency operation for colon perforation at the Department of Surgery, Korea University College of Medicine, from January 1992 to December 2001, 9 patients were diagnosed as stercoral perforation and their medical records were reviewed retrospectively regarding the clinical characteristics, managements and mortality.
Results: The age distribution of the patients was from 32 to 76 years. Male to female ratio was 1.3：1. All patients had history of chronic constipation. Six cases (33.3%) had free air, and 5 cases (55.6%) had fecaloma at preoperative
simple X-ray. The site of perforation were sigmoid colon (8 cases) and descending colon (1 case). The size of perforation ranged from 1 ㎝ to 6.5 ㎝ (mean: 3.1×2.7 ㎝). The methods of operation were Hartmann’s procedure (8 cases), primary repair and sigmoid loop colostomy (1 case). There were two deaths for sepsis.
Conclusions: The stercoral perforation is not rare as commonly thought. If elderly patients who had history of chronic constipation and symptoms of panperitonitis visit hospital, surgeon should be aware of the possibility of this fatal
disease and do early surgical intervention with the aggressive therapy for reducing the mortality.
키워드
숙변성 천공;대장천공
Stercoral perforation;Colon perforation
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