26. Comparison of Surgical Options in Typhoid Ileal Perforation at Tertiary Care Hospital
Inayat Ali Zardari, Abdul Hakeem Jamali, Mashooq Ali Khowaja, Farkhanda Jabeen Dahri, Zulfqar Ali Imtiaz Memon and Altaf Hussain Ghumro
ABSTRACT
Objective: To detect the outcomes of surgical management options in typhoid ileal perforations treated at tertiary care hospital.
Study Design: Comparative study
Place and Duration of Study: This study was conducted at the Surgical Department of PMC Hospital Nawabshah from January 2017 to December 2018.
Materials and Methods: This study included total 100 patients. All patients were admitted from surgical OPD and emergency department of PMCH, Nawabshah. Out of 100, 65 (65%) were females and 35 (35%) were male patients. Age ranged from 30 to 55 and 25 to 45 in females and males respectively. The common mode of presentation was mild to severe pain in abdomen along with distention of abdomen and intermittent/continuos low to high grade fever. Radiological investigations detected free air under right dome of diaphragm. Primary repair, resection, anastomosis and loop ileostomy were made and results were assessed according to condition of the patient.
Results: Out of 100, 45 (45%) were found single perforations of less than 1cm and 1.5 to 2 feet away from ileocecal junction whereas 30 (30%) patients had size of perforation less than 2.5 cm with less contaminated abdominal cavity, 25 (25%) patients had single and multiple perforations of more than 2.5cm size with contaminated abdominal cavity.
Conclusion: Primary repair is the best surgical option to treat ileal perforations. Ileostomy is the better option to treat large multiple perforation with contamination of abdominal cavity and septicemia patients as compared to resection and anastomosis because ileostomy has local complications and resction anastomosis has systemic complications.
Key Words: Ileostomy, Resection, Anastomsis, Primary repair, Typhoid ileal perforation
Citation of articles: Zardari IA, Jamali AH, Khowaja MA, Dahri FJ, Memon ZAI, Ghumro AH. Comparison of Surgical Options in Typhoid Ileal Perforation at Tertiary Care Hospital. Med Forum 2019;30(5):100-103.