A Comparitive study of Morbidity and Mortality in Enteric perforation between Primary repair and Primary Ileostomy with delayed closure
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 4
Abstract
Perforation peritonitis is one of the most common surgical emergency in India and one of its main cause is Typhoid caused by bacterium Salmonella typhi. The spread of infection is usually by faeco-oral route. In underdeveloped countries like India contamination of drinking water and of edibles are major source. Blood culture is the most important diagnostic method. A serological Widal test detects antibodies against bacteria. Surgical intervention has to be carried out as soon as possible. In our Prospective comparative study done in Department of general surgery in Jay Arogya Hospital and Kamla Raja Hospital associated with Gajra Raja Medical College, Gwalior (M.P.) from 01 july 2010 to 30 June 2011. 100 Patients was treated with different surgical management according to the perforation site, size, number, distance from ileocaecal junction, condition of the gut and intraperitoneal contamination and were divided between two groups, Group 1 in which primary repair of perforation was done and Group 2 in which Primary ileostomy was made. Data was recorded on a predefined proforma which was analysed and interpretation was done by using chi Square test. The level P < 0.05 was considered as the cut off value or significance. Overall Morbidity was 41.02% in primary repair group and 65.57% in primary ileostomy group ( p value <0.05) that is morbidity was significantly less in primary repair group. Mortality was 12.82% in primary repair group and 1.63% in primary ileostomy group (p value <0.05) that is mortality was significantly less in primary ileostomy group. In our study we concluded that ileostomy is the life saving procedure, when the life of the patient is at risk in emergency situation due to poor general condition of the gut and the patient. The repair of the perforation can be done in small perforation sufficient away from ileocaecal junction in less contaminated peritoneal cavity with relatively good general condition of the gut and the patient.
Authors and Affiliations
Dr Krishna Kumar Bharang, Dr Mukesh singh Narwariya, Dr Sunil Agrawal
Keywords
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- EP ID EP370325
- DOI 10.9790/0853-1704017276
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