TYPHOID PERFORATION

PRIMARY CLOSURE VS ILEOSTOMY

Abstract

Introduction:- Typhoid fever is an infectious disease caused by a bacterium salmonella typhi. The
spread of infection is usually by an oro-fecal route. Food handlers are a major source of spread in developed countries.
In undeveloped countries like ours, contamination of drinking water and edibles are the major source. Infected shellfish
are occasionally a source of an outbreak. Objectives To review the present practice of managing patients with typhoid
perforation and comparison between the primary closure and exteriorization. Setting Surgical Unit-II, Nishtar Hospital,
Multan. Duration Two years. Patients and methods Sample size 50 patients. Results:- A total of 50 patients were
finalized for the analysis. There were 14 females and 36 males (1:2.5). The age ranged from 18 years to 35 years, the
mean age was 28 years. In patient who underwent ileostomy, death occurred in 3 cases (10%). Most of the patients
belonged to low socioeconomic class. Delay in reaching the hospital was significant for several reasons including
transportation and pretreatment at peripheral private hospitals. 46 patients presented after 48 hours of perforation
(92%). Conclusion:- In cases with good reserves and earlier hospitalization primary repair is certainly the procedure
of choice