Ileostomy in Typhoid Perforation

Abstract

This is a prospective observational study carried out during last five years (Jan, 1998 to Nov, 2002) The purpose was to study guidelines of case selection for different available procedures to treat typhoid perforations. Ninety cases of typhoid perforation were treated by different procedures. The complete records were maintained and a designed protocol of management was observed. Male to Female ratio was 4 to 1. Average age 26 years (7 cases below 10 years and 6 cases above 40 years) Only 17 cases (18.88%) presented within 24 hours, the largest group of 31 cases (34.44%) presented after 72 hours. Although complication rate was very high in the late reporting, no significant mortality difference was noted. Primary ileostomy (group 1) 18 cases had no mortality, 53 cases of simple perforation closure had 5 mortalities (9.43%), resection anastmosis group that is 19 cases had 2 mortalities (10.5%), closure of the ileostomies (19 cases) had no mortality and a very low complication rate. In our study ileostomy is a good life saving procedure to be used judiciously, accepting its inconvenience to the patient.