Clinical Pattern and Management of Typhoid Ileal Perforation
Objective: To determine the clinical presentation of typhoid ileal perforation and its outcome after treatment at tertiary care Hospital.
Material and Methods: This cross-sectional study was carried out in the Department of General Surgery, LUMHS/Jamshoro from October 2010 to September 2011. All the cases presented with typhoid perforation on clinical basis and having X-ray demonstration of air-fluid and gas under the diaphragm were included. In the study all the cases underwent surgical emergency with coverage of broad spectrum antibiotic, nasogastric suction, and correction of fluid. Electrolyte imbalance was occurred and blood transfusion was done before the surgery. All the data regarding clinical presentation, postoperative complications and mortality was recorded in the proforma. Data was analyzed by SPSS version 16.
Results: Total 40 patients were studied. Mean age of the patients was 27.08+22.0 years with the range of 10 to 60 years. Most common 82.5% were male and 17.5% was female. Abdominal pain and tenderness were found in all the cases. Regarding signs and symptoms, abdominal distension (97.5%) and fever (95%) were the most common presented. Primary closure in two layers was done in 40.0% cases, segmentation resection end to end anastomosis procedure was done in 10.0% cases and primary repair with proximal ileostomy was done in 50.0% cases. Wound infection was developed in 62.5% patients followed by wound adhesion in 30.0% cases. Mortality rate was 10.0%.
Conclusion: We observed wound infection and wound adhesion were the commonest complications with mortality rate was 10%.
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