Typhoid perforation presentation and management by ileostomy

Shakiba Sarwar, Iqra Abbas, Iffat Tahira


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.


Typhoid perforation, ileostomy, Enteric fever, peritonitis

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Gupta S, Kaushik R . Peritonitis– the Eastern experience. World Journal of Emergency Surgery 2006;1:1-13.

Kapoor V K, Mishra M C, Ardhanari R , Chattopadhyay T K, Sharma L K. Typhoid enteric perforations. Surgery Today 2006;15(3):205-8.

Nuhu A , Dahwa S, Hamza A. Operative management of typhoid ileal perforation in children. Afr J Paediatr Surg 2010;7(1):9-13.

Akgun Y, Bac B, Boylu S, Aban N, Tacyildiz I. Typhoid enteric perforation. British Journal of Surgery 1995;82(11):1512-5.

Adeniran J O , Taiwo J O , Abdur-Rahman LO. Salmonella in-testinal perforation. Journal of Indian Association of Pediatric Surgeons 2005;10(4): 248-51.

Talwar S, Sharma R K, Mittal D K, Prasad P. Typhoid enteric perforation. ANZ Journal of Surgery 2008;67(6):351-3.

Eustache J, David J. Kreis. Typhoid Perforation of the Intes-tine. Arch Surg 1983; 118(11):1269-71.

Eid H O, Hefny A F, Joshi S, Abu-Zidan F M. Non-traumatic perforation of the small bowel. Afr Health Sci. 2008 ; 8(1): 36–9.

Wani R A , Parray F Q , Bhat N A , Wani M A , Bhat T H, Farza-na F. Nontraumatic terminal ileal perforation. World Journal of Emergency Surgery 2006;1 :7.

Ansari A G, Naqvi S Q H, Ghumro A A, Jamali A H, Talpur A A. Management of typhoid ileal perforation:a surgical experi-ence of 44 cases. Gomal Journal of Medical Sciences 2009; 7(1): 27.

Kouame J, Kouadio L, Turquin H T. Typhoid Ileal Per-foration Surgical Experience of 64 Cases. Acta chir belg 2004;104:445-7.

Na’aya H U, Eni U E, Chama C M. Typhoid perforation in mai-duguri, Nigeria. Annals of African Medicine 2004;3(2):69-72.

Malik A M, Laghari A A, Mallah Q, Qureshi G A, Talpur A H, Effendi S, Memon J M. Different surgical options and ileos-tomy in typhoid perforation. World Journal of Medical Sci-ences 2006;1(2):112-6.

Hosoglu S, Aldemir M, Akalin S, Geyik M F, Ibrahim H. Tacy-ildiz, Mark Loeb M. Risk factors for enteric perforation in pa-tients with typhoid fever. Am J Epidemiol 2004;160:46-50.

Meier D E, Tarpley J L. Typhoid Intestinal Perforations in Ni-gerian Children. World Journal of Surgery 1998;22(3):319-23.

K Park. Epidemiology of cummunicable diseases. In: Park Text-book of Preventive Medicine. 18th ed. Jan 2007. p; 187- 189.


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