1. Mohammad Tahir 2. Sohail Aziz 3. Qazi Tahir-uddin

1. Prof. of Surgery, 2. Assoc. Prof. of Anatomy, 3. Assoc. Prof. of Surgery, KMU-IMS, Kohat  

ABSTRACT

Objective: To see the benefits of primary closure in typhoid intestinal perforation in early cases, regarding morbidity and mortality in KPK. Study Design: Prospective study

Duration and Place of Study: study was performed at teaching hospital of KMU-IMS, Kohat from March 2006 to March 2014.

Material and Method: In this prospective study, we included 76 cases of single perforation of less than 24 hours in terminal ileum in typhoid fever patients, these patients had primary closure in 2 layers. Data was collected on a structured proforma. Patients’ data included demography, clinical features, investigation post-operative complications, hospital stay and follow up.

Results: 76 cases were included in the study over 8 years. Mean age was 24 ±10.32 years with m:f ratio of 1:2.6. In 100 % cases pain abdomen, fever, tenderness in either right iliac fossa or generalized in the abdomen were observed. Widal test, Typhidot and blood culture  was positive in 51 ,54 and 58 out of 76 patients in same order.

Wound sepsis was a common post-operative complication 12/76(15%) other post-operative complications were pulmonary infection, abdominal dehiscence, intra peritoneal abscesses and Intestinal haemorrhage. Mean duration of hospital stay was 13.34 ±4.20 days. Mortality was 1.3%

Conclusion: Two layer primary closure is an effective procedure having good results. Both morbidity and mortality are low and associated with reasonable length of hospital admission. Key Words: Perforated Tleum, Primary Closure, Complication of typhoid

Citation of article: Tahir M, Aziz S, Tahiruddin Q. Role of Primary Closure in the Management of Early Cases of Typhoid Intestinal Perforation, in Our Set Up.  Med Forum 2015;26(3):40-43.