Comparative study of primary repair versus ileostomy in patients of typhoid perforation

Abstract

Objective: To evaluate the better surgical option in cases of typhoid perforation comparing ileostomy and the primary repair. Study design: It was a cross sectional comparative study. Place and duration of study: Department of Surgery, Nishtar hospital Multan during December 2003 to November 2004. Patients and methods: A total of 50 cases of typhoid perforation which presented in less than 24 hours after perforation. The patients were divided into two groups of 25 patients each in double blind randomized pattern. In one group ileostomy was done and in the other group primary repair was done. Results: The mortality rate in the ileostomy was 8% and the morbidity rate was 56%. In the patients with primary repair the mortality rate was 12% and the morbidity rate was 24%. Conclusion: If patient present within 24 hours after perforation provided that the patient is in good general health and with no other concomitant illness primary repair of the typhoid perforation should be done in every patient.