非外傷性小腸穿孔常會引起腹膜炎,而在外科治療腹膜炎之手術中,因非外傷性小腸穿孔引起的並不多見。非外傷性小腸穿孔因不多見,而且有眾多病因會引起,所以術前的診斷很困難,加上它有相當高的死亡率,所以它是一種很危險的疾病,而且也是外科醫生的一項挑戰。為了使外科醫生對此疾病有更多認識,從1985年至1994年,我們對本院的25個病例加以分析討論;其中8個病例為腸沾黏阻塞所引起穿孔,7個病例為不明原因所引起,4個病例為外物引起,3個病例為惡性腫瘤引起,2個病例為腹內疝氣所引起,有一位病例為膜繭造成腸阻塞所引起。有18個病例接受小腸部分切除及接合手術,7個病例接受傷口擴創切除及縫合手術。其中有9個病例死亡,死亡率為百分之三十六。
Nontraumatic perforation of small intestine is a rare cause of the peritonitis requiring immediate surgical treatment. The difficulty in preoperative diagnosis due to diverse etiologies and high mortality rate indicate the danger of this disease. A retrospective review of 25 patients treated at our hospital from 1985 to 1994 was performed, with following etiologies: adhesion (8 patients), idiopathic (7 patients), foreign body (4 patients), malignancy (3 patients), internal herniation (2 patients) and cocoon disease (1 patient). The segmental resection was performed for 18 patients and the excision of lesion with oversewing was performed for the remaining 7 patients. Nine patients died with 36 percents mortality rate.