Shoji Matsui

A CASE OF INFANTILE IDIOPATHIC GASTRIC RUPTURE

Emergency operations including suture of the stomach and celiac drainage were performed for a 5-day-old male infant who developed idiopathic gastric rupture. E. coli was detected from the acites and blood, and the infant was diagnosed as general peritonitis associated with septicemia. The life of the baby could be saved by intensive postoperative management. On the 13th postoperative day, inflammation with necrosis of the right spermatic cord and testis as well as perianal abscess occurred, which were sucessfully cured by incision of the scrotum with drainage for the abscess, right orchiectomy, and incision of perianal abscess with drainage.

SURGICAL TREATMENT OF BLEEDING GASTRODUODENAL ULCER IN THE VIEW OF RISK FACTORS

出血性胃十二指腸潰瘍75例の治療成績から予後に影響を及ぼす背景因子について検討を加えた. 潰瘍入院総数に対する出血率は22.4%で, 手術の内訳は緊急32例, 待期27例で, 死亡率は緊急21.9%, 待期3.7%と緊急の予後が著しく悪かった. また加齢につれて死亡率は上昇し70歳以上の高齢者では19例中6例 (31.6%) であった. 予後に影響を及ぼす重要な背景因子は年齢と併存症で, シメチジン出現以後, 年度別の出血例は減少したが, 入院数に占める出血率には変化なく, 緊急手術率は前期に比べて増加した.従って, 併存症を有する高齢者に対しては保存治療に固執することなく手術適応を考慮して手術時期を失しないよう迅速に対処することが必要である.