Læknablaðið - 15.01.2005, Blaðsíða 48

1 945-1954 / MAGA- OG SKEIFUGARNARSÁR
Helstu heimildir
Heilbrigöisskýrslur 1902-1945.
Mannfjöldaskýrslur 1911-1940.
Skýrslur Landspítalans 1930-1945.
Jónas Sveinsson: Perforatio ventriculi ete Zbl.; f. Chir, nr. 23,1933.
Ólafur Ó. Lárusson: Sprungin maga- og skeifugarnarsár. Lbl. 22. árg.
1936.
Bartel Bager: Beitrag zur Kenntnis iiber Vorkommen, Klinik und
Behandlung von perforierten Magen und zwölffinger-darmgesc-
híiren etc. Stockholm 1929.
Henry L Bockhus: Gastro-Enterology Vol. I. S. 516.
Brun G og Landelius E.: La resection radiente dans la maladie ulc-
ereuse. chr. J. internat. de chirurg. Jan.-Feb. 1947.
Leuer C. A.: Acut Perforation of Stomach and Small bowell ulcerat-
ion etc. Surgery. March 1949, s. 404.
Finsterer H.: Gastric and Duodenal Uicers and their Complications
J. internat. College of Surgeons. Sept.-Okt. 1949, s. 599.
Vinck A. Hedley: Conservativ Treatment of acut perforated peptic
Ulcer. Britt. med. Journ. Dec. 1946
Sam F. Seeley o.fi.: Nonoperativ Treatment of perforated Duodenal
Ulcer. Ref. i Aurer. J. of Digestive Diseases Sept. 1949, S. 341
Hall W. W.: A Case of Perforating Gastric Ulcer, Perionitis, Reco-
very Ref. of Shipley og Walker í Amer. J. of Surgery March 1949,
s. 329.
English summary
The St. Josephs Hospital in Reykjavík opened on the
1st of Sept. 1902. Until 1930 it was the main hospital of
South lceland.
During the first 21 year period or until October 22nd
1923, not a single case of perforated peptic uncer
seems to have been diagnosed nor treated in this hospi-
tal nor in any other hospital in the country.
Neither is there any death from perforated pept. ulcer
reported in the public health register of this period with
only one exception in the year 1912.
During the following 25 year period (1923-1948) 27
cases of an acute perforation and 8 cases of a subacute
perforations (perf. larvata) of peptic ulcerations were
admitted to and operated on in the St. Josephs Hospital
and further 8 cases were given surgical treatment (reop-
eration) for the sequelæ of an acute perforations that
primarily had been operated on in other hospitals.
There is thus a total of 42 cases as one of them is
counted twice (in group 1 and 3). - In the first group
there were two women, in the second group one woman
and in the third group none. -The relation between the
sexes thus being 39:3 for all three groups.
Ulcers of the duodenum and pylorus were prevalent
in all 3 groups (being 35 cases against 7 gastric ulcers).
Two cases had perforated twice and 3 had perforated in
the hospital.
The treatment was surgical in all cases. - A simple
closure of the ulcerperforation was made in 26 cases of
the first group, but in one case a costal resection was
done and no laparotomy.
The immediate operative fatalities amongst those who
underwent a laparotomy were 2 i. e. 7, 8 percent (or 7, 4
percent amongst all 27 cases).
Eleven of the remaining 25 cases had to be reoperat-
ed on later because of the same disease or its compl-
ications (with one immediate fatality). Two more of them
are dead, one from cancer of the stomach 5 years later
(39 years old) and the other from a recurrent intestinal
obstruction, the others (9) are still alive (1949) and are
enjoying good health.
Of the 14 not operated, 9 had a good or a fairly good
result from the primary operation, 2 had a bad result and
2 have succumbed late on, one fram apoplexia, the ot-
her from an accident. - On couldn't be traced (foreigner).
In the 2nd and 3rd group a G. E. anast. was done en
12 cases, an excision of the ulcer and G. E. anast., a
gastrectomy and an exploratory laparatomy in one case
each.
In 14 cases the result has been good, bad in one
case, they are all alive, with one exception, who died
from cancer of the stomach five years later, at the age
of 28.
Approximately some 100 cases of an acute perforat-
ion of peptic ulceration are known to have had surgical
treatment in all the hospitals of lceland1)during this 25
year period (1923-1948).
The immediate operative mortality as far as the author
could trace amongst 87 of the cases does not seem to
exceed 13 percent.
1) The population of the
country had increased from
about 100.000 to 138 thou-
sand during this period.
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