부산대학교 도서관

A 73-year-old, bed-ridden woman with strictures of both upper and lower limbs had been living in an old age home ; she could barely communicate with the staff when admitted to hospital with a simple intestinal obstruction. Her family doctor discussed her condition with her family ; it was decided that surgery would only be done for urgent conditions which could be treated easily. She was managed with an intestinal decompression long tube, which dislocated in the peritoneal cavity. Her family was informed that she had an esophageal perforation by her family physician since an urgent operation was required, she was transferred to our center and underwent the surgery. During the operation a strangulated intestinal obstruction and esophageal perforation caused by the decompression long tube were found. The necrotic intestinal loop was resected, and a simple closure of the esophagus was done. She was transferred to the referring hospital on the 13th hospital day. Informed concent for the urgent operation could be easily obtained and the patient could be quickly transfered to the referring hospital because the patient's family doctor had maintained a good relationship with the patient's family.