Ileostomy in the Treatment of Typhoid Enteric Perforation Among Patients Presenting Late in The Hospital
Shandana Gul, Mahwash Anjum Shafiq, Fazal-e-Nauman
3360
ABSTRACT
Introduction: Typhoid enteric perforation
is a communal acute emergency of abdomen in our hospital settings. Maximum
patients in Pakistan come from rural zones and have a serious illness when
presented in the laten final stages.
Objective: To govern the importance
of an ileostomy in cases of late presentation with enteric perforation.
Study
Design:
A retrospective study.
Place
and Duration:
In the surgical Department of Islam Medical College and Teaching Hospital
Sialkot for one year duration from July 2020 to July 2021.
Methods: 52 total patients of
typhoid enteric perforation were included in our department. 5 to 32 years was
the age range of patients with an average age of 16 years. Most of these
patients have complaints of fever, abdominal pain, abdominal distension and
vomiting
Results: 52 patients with late
presentation of typhoid perforation were alienated into 2 groups. All cases of
group A underwent laparotomy and perforation exteriorization was done as loop
ileostomy. In group A, when exteriorization was performed as the first
procedure, fecal fistula was later developed in 12 cases. Ten of these cases
had to be re-examined and the second perforation was found to be close to the
original one. The mortality was observed in three cases.
Conclusion: In a relatively
normal-looking intestine, restoration of the margin, closure of the two layers
of perforation, and ileostomy near the perforation are safer in the case of
late onset of typhoid fever enteric perforation.
Keywords: typhoid perforation,
double-layer closure and ileostomy