Typhoid ileal perforation: comparative study of ileostomy versus primary ileal repair and associated morbidity and mortality

Abstract

Background: Enteric perforation is most frequent encountered acute surgical emergency in Northern India and immediate warrants operative intervention. But the kind of intervention, whether primary repair or ileostomy is always a topic of debate for a long era.Methods: Sixty cases of ileal perforation were studied retrospectively from Feb. 2016 to august 2017 and information had been accumulated on clinical presentation, demographic profile and laboratory data. Details were obtained for operative findings and appropriate method of operative intervention done and later postoperative course of the patients in fallow up.Results: Ileal perforation occurred mostly in young males (age 28.2±10.9 years). Male and Female ratio has been found to be 5: 1. In present study 60% of patients had Widal positive supporting typhoid aetiology; Blood culture was positive for salmonella typhi in 21 (35%) cases. 67.3% of patients underwent primary closure, while 32.7% underwent ileostomy. Nature of clinical presentation, laboratory data and operative findings in both groups has been thoroughly analysed.Conclusions: Authors have carried out this study to label some of the preoperative and intraoperative factors, which can serve as a guideline for decision making in operative intervention in a specific patient.