한국인에 있어서 대장외과의 특이성

Abstract

[한글]

[영문]This clinical study of surgical diseases of large intestine in Korea was done with those patients who have been diagnosed histologically and treated surgically from 1952 to 1967 at Yonsei Medical Center and with articles which had been reported by several authors in Korea.

Intestinal tuberculosis is still frequently seen in Korea where the number of active pulmonary tuberculosis cases is as high as 5.1 percent of all populations, while the disease is extremly rare in western countries since the use of antituberculous agents. Because there are no typical symptoms and signs in tuberculous colitis, and also because of occasional difficulty in differentiating tuberculosis of the colon from colonic carcinoma, it is often a candidate of operative disease of large bowel in Korea.

Although diverticulosis and diverticulitis of large bowel is one of the most common disease in geriatrie patients in America and Europe, it is one of the extremly rare diseases in Korea. We presume that this phenomena is due to diet habit; possibly the low residue diet in the west may delay the propulsion and accentuate the dessication of the intracolonic contents, causing increased pressure within lumen thereby develops the diverticulosis around the sigmoid colon.

Ulcerative colitis and polyposis of the colon are decidely rare in Korea in comparison with western countries.

The carcinoma of the large bowel is less frequent seen in Korea than in the west where it is most common cancer. We are of the opinion that the low rate of incidence of the carcinoma of large bowel is due to the following factors; first, the low rate of incidence of polyp and ulcerative colitis which thought premalignant lesion in colon, second, the living conditions including diet.

Crohn's disease was at first described as "terminal ileitis" but later similar pathologic changes in stomach and large bowel have been reported. In several cases that we have studied, Crohn's disease was located more often in the large bowel than in terminal ileum unlike the cases reported in western countries.