A Prospective Study on Management of Typhoidal Ileal Perforation

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.Aim:  To determine the role of ileostomy in the management of ileal perforations caused by typhoidal disease. Methods: Sixty cases of ileal perforation were studied prospectively over a period of 03 years from July 2016 to June 2019 at  Anugrah Narayan Magadh Medical College and Hospital, Gayaand 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 were follow 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. 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.