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 42±10.47 years. We found that 12(21.81%) patients in the primary repair group and 24(43.63%) in the ileostomy group developed wound infection (p0.05). 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

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