腹腔內 結核의 臨床的 考察 = Clinical Studies of Intra-Abdominal

다국어 초록 (Multilingual Abstract)

Clinical studies on thirty one surgical patients with intraabdominal tuberculosis who were admitted to.the department of surgery. Wonju Union Christian Hospital from November 1959 to December 1965 are presented.
The ratio of male to female is 1 : 2.4, and the predominant age incidence is the second and third decades of life. About forty three per cent of the female group who had been married for three years or more showed sterility. The main symptoms were abdominal pain, weakness, anorexia, indigestion, abdominal distention and constipation. The cardinal signs were abdominal tenderness, abdominal distention, ascites and palpable masses. Hemoglobin of less than i0 gms was noted in 22.6 per cent. Leucocytosis greater than 10,000 was noted in 38.7 per cent. We were able to make a correct diagnosis preoperatively in only 9 cases and the other were misdiagnosed as; intestinal obstruction, appendicitis, mesenteric tumor, carcinoma of the stomach, ovarian cyst, liver cirrhosis, pelvic tumor, superior mesenteric artery syndrome, primary sterility, ectopic pr gnancy, perforated peptic ulcer and liver abscess. Post-operative diagnosis disclosed tuberculous in 80.6 per cent, tuberculous of the intestine in 12.8 per cent, tuberculous salpingitis in 9.6 per cent and tuberculous lymphadenopathy in 3.2 per cent.
There was a close relationship between tuberculosis of the respiratory system and infra-abdominal tuberculosis evidenced by the fact that there was active or inactive tuberculous lesions in the chest films of 93.4 per cent of cases. About 45 per cent of the cases had acive pulmonary tuberculosis, 35.4 per cent of the cases had inactive pulmonary tuberculosis and 12.9 per cent had pleural lesions. These figure indicate that intra-abdominal tuberculosis is more likely to be secondary to tuberculoris of the respiratory system. Complications noted in this series were intestinal obstuction in 9 cases(29.0 per cent) and one each of ectopic preganey and perforated ileum. The predominant opertive finbings were tubercles, adhesions, ascites, caseated nodes and thickened peritoneum. The operative methods used were exploratory laparatomy with biopsy, segmental resection with end to end anastomosis of the bowel, lysis of adhesions. by-pass operation, hysterectomy, salpingectomy, salp ingoplasty and incision: and drainage.