Typhoid perforation presentation and management by ileostomy
Objective: To determine different ways of presentation of typhoid perforation and its management by ileostomy.
Study design & duration: This is a cross sectional study started in January 2018 and completed in July 2018 consisted on total duration of 7 months.
Setting: Study was conducted in general surgery ward of bahawal Victoria hospital Bahawalpur.
Patients and methods: Total 60 cases were included in this study diagnosed with typhoid perforation of intestine. They were planned for surgery. Two groups were formed. 35 cases kept in group-A and 25 were kept in group-B. Group-A cases were planned for laparotomy and ileostomy. While in group cases ileostomy was not done. Out come in boh cases were observedAll relevant data such as age, gender, diagnosis, history and important points of physical examination were documented properly. Anesthesia fitness of all cases was taken before operation. These cases were retained in the ward for 2-10 days.
Results: All 60(100%) cases presented with abdominal pain, fever was present in 45(75%), vomiting was presenting sign in 39(65%) and abdominal distension was seen in 40(66.7%) cases. There were 35(58%) cases in group-A, 25(42%) in group-B. In group-A wound infection was seen in 14(40%) cases, wound dehiscence in 6(17%), fecal fistula in 25.7%, re-exploration in 7(20%) and mortality in one case. In group-B wound infection seen in 5(20%) cases, wound dehiscence in 2(8%) cases, fecal fistula in 3(12%) cases, re exploration done in 2(8%) and mortality rate was 8% as well.
Conclusion: In typhoid perforation ileostomy is a safe method to avoid much complications with better outcome as compared to anastomosis in first surgery with ileostomy.
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