Abstract
Twenty-six cases of perforation of the small intestine were experienced in a recent one decade. These perforations were caused by abdominal injury in 15 cases, ingested foreign body in 5, malignant tumor in 2. Meckel's diverticulum, incarcerated internal inguinal hernia and Crohn's disease in each one. The average age of 26 patients was 476 years old. The male-to-female ratio was 19.7. All cases complained of abdominal pain at the first examination. Shock was observed in 5 patients. Seventy per cent didn't have a fever. The increase in WBC was observed in 80% of the cases and the mean was 14400/ml. In only 17% of the patients the intra-abdominal free air was confirmed in X-ray films. We did not point out intra-abdominal ingested foreign bodies preoperatively. In most cases diagnosis of acute panperitonitis was made and laparotomy was performed. Only 3 patients, whose perforations were caused by abdominal injuries, could be diagnosed before surgery. Simple closure of the perforation and partial resection were carried out to almost same number of the patients. Postoperative complications were noted in 42% of them, operative death due to endotoxin-shock occurred in one patient. It is difficult to diagnose the perforation of the small intestine preoperatively, because many kinds of disease can cause the perforation and no characteristic symptoms are known. We should try to perform the operation as early as possible.
