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Original Research 
RMJ. 2020; 45(2): 406-409


Outcome of primary repair versus ileostomy in patients with typhoid ileal perforation

Neelma, Uzair Ahmad, Haroon Khan, Yousaf Jan, Syeda Maryam Ilyas, Abdul Salam.

Abstract
Objective: To compare the primary repair and ileostomy in patients with typhoid ileal perforation in terms of clinical outcome and post-operative complications.
Methodology: This randomized study was conducted at Department of Surgery, Hayatabad Medical Complex, Peshawar, from April 2017 to April 2019 and included 110 patients using consecutive non probability sampling technique. Typhoid ileal perforation was diagnosed on the basis of history, physical examination and investigations like leukocytosis, positive typhidot and pneumoperitoneum on X ray erect abdomen. The patients were divided into two groups using lottery method. Group A underwent primary repair and Group B underwent ileostomy. The procedures were performed by highly experienced surgeons. Patients were followed at 2 weeks, 1 month and 3 months after surgery. Data were analyzed using SPSS version 22. Hospital stay in both groups was compared using independent t-test and post-operative complications were compared using Chi-square test.
Results: Out of 110 patients, 55 were in each group; 90(81.82%) were male and 30(27.27%) female. The mean age was 4210.47 years. We found that 12(21.81%) patients in the primary repair group and 24(43.63%) in the ileostomy group developed wound infection (p<0.05). Two(3.63%) patients in the primary repair group compared to 5(9.09%) in the ileostomy group developed wound dehiscence (p >0.05). Two(3.63%) patients in the primary repair group while none in the ileostomy group developed fecal fistula (p>0.05). Four(7.27%) patients in the ileostomy group while none in the primary repair group developed stoma retraction (p<0.05). We found that 17(30.90%) patients in the primary repair group and 35(63.63%) in the ileostomy group developed complications (p<0.05). The mean hospital stay after the primary repair was 6.782.1 days compared to 9.29 2.88 days after the ileostomy (p=0.000).
Conclusion: Early surgery and adequate resuscitation is the key to success in the proper management of typhoid ileal perforation. We found that primary repair was superior to ileostomy.

Key words: Enteric fever, Typhoid ileal perforation, stoma retraction, wound dehiscence.


 
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How to Cite this Article
Pubmed Style

, Ahmad U, Khan H, Jan Y, Ilyas SM, Salam A. Outcome of primary repair versus ileostomy in patients with typhoid ileal perforation. RMJ. 2020; 45(2): 406-409.


Web Style

, Ahmad U, Khan H, Jan Y, Ilyas SM, Salam A. Outcome of primary repair versus ileostomy in patients with typhoid ileal perforation. http://www.rmj.org.pk/?mno=78661 [Access: May 10, 2020].


AMA (American Medical Association) Style

, Ahmad U, Khan H, Jan Y, Ilyas SM, Salam A. Outcome of primary repair versus ileostomy in patients with typhoid ileal perforation. RMJ. 2020; 45(2): 406-409.



Vancouver/ICMJE Style

, Ahmad U, Khan H, Jan Y, Ilyas SM, Salam A. Outcome of primary repair versus ileostomy in patients with typhoid ileal perforation. RMJ. (2020), [cited May 10, 2020]; 45(2): 406-409.



Harvard Style

, Ahmad, . U., Khan, . H., Jan, . Y., Ilyas, . S. M. & Salam, . A. (2020) Outcome of primary repair versus ileostomy in patients with typhoid ileal perforation. RMJ, 45 (2), 406-409.



Turabian Style

, Uzair Ahmad, Haroon Khan, Yousaf Jan, Syeda Maryam Ilyas, and Abdul Salam. 2020. Outcome of primary repair versus ileostomy in patients with typhoid ileal perforation. Rawal Medical Journal, 45 (2), 406-409.



Chicago Style

, Uzair Ahmad, Haroon Khan, Yousaf Jan, Syeda Maryam Ilyas, and Abdul Salam. "Outcome of primary repair versus ileostomy in patients with typhoid ileal perforation." Rawal Medical Journal 45 (2020), 406-409.



MLA (The Modern Language Association) Style

, Uzair Ahmad, Haroon Khan, Yousaf Jan, Syeda Maryam Ilyas, and Abdul Salam. "Outcome of primary repair versus ileostomy in patients with typhoid ileal perforation." Rawal Medical Journal 45.2 (2020), 406-409. Print.



APA (American Psychological Association) Style

, Ahmad, . U., Khan, . H., Jan, . Y., Ilyas, . S. M. & Salam, . A. (2020) Outcome of primary repair versus ileostomy in patients with typhoid ileal perforation. Rawal Medical Journal, 45 (2), 406-409.








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