TYPHOID PERFORATION OF ILEUM: AN EXPERIENCE OF 60 CASES

Abstract

Aims: The aim of our study was to collect data on Ileal perforation due to Enteric fever in this part of thecountry and share our experience in the management of this common surgical emergency in the underdeveloped countries.Material and Methods: This was a prospective study carried out on 60 patients admitted and operated fortyphoid perforation of ileum in the department of surgery Saidu Teaching Hospital over a period of threeyears. A proforma was designed for this study based on history, examination, investigations, pre-operativetreatment, operative findings, post operative complications and mortality.Results: Sixty (60) patients were enrolled in this day who were operated on the day of their admission. Allhad single perforation in the distal ileum. Ileostomy was constructed in all patients. The mortality was3.33% in our study as compared to 57-58.9% with simple closure, 8.8% with wedge excision and reanastomosis and 80% in patients treated conservatively. Other complications included, Skin excoriation23.33%, wound infecdon 21.66%, wound dehiscence 6.66%, intra -abdominal abscesses 5.00%, ileostomyprolapse 5.00%, ileostomy retraction 6.66% and pleural effusion 1.66%. There was no faecal fistula and reperforation in our cases.Conclusions: Ileostomy for enteric perforation of ileum being associated with low morbidity and mortalityis recommended for all cases and particularly for those patients having gross contamination.Key words: Typhoid Ileal perforation, Ileostomy, morbidity, mortality.