Shaukat Ali, Muhammad Amjad Amin, Abdul Sattar.
Typhoid perforation; primary closure vs ileostomy.
Professional Med J Jan ;13(2):269-73.

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 re asons 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

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