Hassan F, Rajan Kr Sinha, Pd J, Pratap V, Dksinha.
Ileostomy in management of typhoid enteric perforation presenting late: an experience at tertiary-care hospital, Jharkhand, India.
Pak J Surg Jan ;26(2):108-10.

Background: Typhoid enteric perforation is a common acute abdominal emergency in our hospital. Most of our patients come from rural areas and presented late in severely morbid condition. Objective: To determine the role of ileostomy in the cases of enteric perforation presenting late. Study design: It is a retrospective study. Setting: All cases of enteric perforation admitt ed in the Department of General Surgery, RIMS, Ranchi, Jharkhand, India. Materials and methods: The study includes all cases of enteric perforation presented as peritonitis from June 2007 to December 2008 in Rajendra Institute of Medical Sciences, Ranchi. Results: 46 cases of late enteric perforation were admitt ed at RIMS, Jharkhand, India. In 26 cases, exteriorization of the ileal perforration was done; 11 of these cases subsequently developed leakage from surrounding ileum, needing laparotomy. 20 of the cases had double layer closure of perforation and ileostomy from healthy bowel; only two of these cases presented with perforation and peritonitis. Conclusion: Refreshing of edges, double layer closure of perforation and ileostomy proximal to perforatoin in a relatively normal looking bowel is a safer procedure for typhoid enteric perforation presenting late.

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