大腸穿孔の臨床的検討

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  • A clinical study on perforated cases of the colon.

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We reviewed in 21 cases of colonic perforation experienced, sites of perforation, its causes, the clinical signs, time and types of the operations performed and their postoperative courses. 21 cases (21.6%) out of the 97 cases of perforation of the alimentary tract excluding cases of appendicitis were those of colonic perforation, and 12.1% of the 173 cases of operation performed of the colon were those of colonic perforation. Though it was not always easy to make diagnoses of perforation of he colon definitely because of the low 33.3% recognition rate for free air in the peritoneal cavity, we were able to operate on 11 cases (52.4%) as early as 6 hours after onset of the disease and to save all the cases. We studied 8 cases of perforated carcinoma of the colon (6.1% of all operated cases of cancer of the colon) and applied curative dissection in all 8 cases. The 5-year survival rate (Kaplan-Meier method) in the perforated cases was not significantly different from that in the non-perforated cses. so even in perforated cases of cancer of the colon, active curative treatment should be performed.

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