Sprungin maga- og skeifugarnarsár í St. Jósefsspítala í Reykjavík til ársloka 1948

Abstract

The St. Josephs Hospital in Reykjavík opened on the 1st of Sept. 1902. Until 1930 it was the main hospital of South Iceland. 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 hospital 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 (reoperation) for the sequelae 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 reoperated on later because of the same disease or its complications (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 other 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 perforation of peptic ulceration are known to have had surgical treatment in all the hospitals of Iceland 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.