Comparison between primary repair and exteriorization in cases of Typhoid perforation

Abstract

Objectives: This comparative study was conducted at Mayo Hospital, Lahore from April 2004 to May 2005 to compare the results of primary repair and exteriorization in cases of typhoid perforation Materials and methods: :80 patients were selected out of which 48 were males and 32 were females. Inclusion criteria: Consisted of a history of fever abdominal pain, constipation, sharp shooting pain superimposed over the colicky abdominal pain clinical finding included tense tender abdomen and absent bowel sounds, investigations including gas under diaphragm in abdominal x-ray and positive widal test. Exclusion criteria: Consisted of negative Widal test even if there was gas under diaphragm, per op findings suggestive of tuberculosis or histopathology reports suggestive of tuberculosis or any pathology other than typhoid. Primary repair was done in patients who presented within 36 hrs of experiencing sharp shooting pain and per op findings of minimal contamination. Exteriorization in the form of loop or double barrel ileostomy was done in other cases.

Surgical Audit of Patients with Ileal Perforations Requiring Ileostomy in a Tertiary Care Hospital in India

“…These procedures though appealing are not free of complications especially in an emergency setup. Of all the postoperative complications reported, faecal fistula remains the most life-threatening; the rate of its occurrence has been reported to be around 12% with a very high mortality rate [14]. In view of this alarming situation, a shift in favour of a defunctioning protective ileostomy has been observed in recent years.…”

Pattern of ileal perforation in our experience; a tertiary care centre in Eastern India

“…Among the entire postoperative complication faecal fistula is the most dreaded complication due to primary bowel anastomosis with occurrence rate found to be about 12% in previous study. 16 Wound sepsis is the most common complication observed in our study. Post-operative complications and mortality rate are found to be high in patients admitted after the long elapsed time after the occurrence of symptoms and the hospital admission and similar observation found by previous study.…”

Epidemiological Study of Ileal Perforation in Patients Presenting to Tertiary Care Centre in North-West Rajasthan

“…About 64% of all patients in this series experienced complications overall. According to published research, the morbidity rate for typhoid perforations ranges from 28.5% to 81% [16][17][18][19]. Typhoid perforations had a 70% complication rate in this series.…”