Spontaneous Ileal perforation and Experience of 33 Cases

Abstract

Intestinal perforation due to typhoid fever and tuberculosis is a frequently encountered surgical emergency in under developed tropical countries. They have abrupt onset and a rapid down hisll course. We want to share our experience in the management of this problem. This prospective study included a total of 33 patients, including thirty (30) with typhoid and three(3) with tuberculous perforation. In typhoid with single perforation, simple repair was performed as a procedure of choice. in multiple perforations, Friable gut and in tuberculous perforation. in typhoid with single perforation, simple repair was performed as a procedure of choice. In multiple perforations, friable gut and in tuberculous patients segmental resection of apparently diseased part, followed by primary end to end anastomosis was performed. The mean age of our patients was 26.27 years. The mean age of typhoid group was 26.8 years and that of tuberculous patients 25.67 years. Male 27 patients (81.82%) females 06(18.18%). Typhoid group: Male 25 patients (83.33%) female 5 patients (16.67%). tuberculous group: male 2 patients (66.67%) female one patient (33.33%). Five patients developed small gut fistulae, 07 wound dehiscence and 03 incisional herniae. the average hospital stay was 11.03 days. the average hospital stay of typhoid group (12.03 days) was signficantly more (p<.01) than tuberculous group (6.33 days). three patients died and the overall mortality was 9%). Intestinal perforations due to tuberculousis and typhoid have high morbidity and mortality.