Enteric Ileal Perforation Primary Repair versus Loop Ileostomy

Tariq Farooq; Muhammad Umair Rashid; Muhammad Faisal Bilal Lodhi; Shahbaz Ahmad; Ahmad Farooq

doi:10.29054/apmc/2011.526

Tariq Farooq Associate Professor of Surgery Punjab Medical College, Faisalabad
Muhammad Umair Rashid Registrar, Department of Surgery DHQ (Teaching) Hospital, Faisalabad
Muhammad Faisal Bilal Lodhi Associate Professor of Surgical Unit III Allied Hospital, Faisalabad
Shahbaz Ahmad Senior Registrar Allied Hospital Faisalabad
Ahmad Farooq House Surgeon DHQ (Teaching) Hospital, Faisalabad

DOI: https://doi.org/10.29054/apmc/2011.526

Keywords: enteric perforation, loop ileostomy, primary repair

Abstract

Objectives: The aim of this study was to record the outcome of enteric ileal perforation, managed by primary repair versus ileostomy in terms of post-operative complications, mortality rate and hospital stay. Design and Duration: Quasi experimental study from January, 2009 to August, 2010. Setting: Surgical Unit-V, District Headquarters (Teaching) Hospital, Punjab Medical College, Faisalabad. Methodology: During the period of study 46 patients of enteric ileal perforation were divided in two groups on consecutive sampling basis. Detailed data of each patient including presentation, operative findings, procedures performed, post-operative outcome and histopathology was entered on a specially designed proforma. The main outcome measures found significant were post-operative complications, hospital stay and mortality rate. The data was compiled and analyzed by using SPSS-1B. Results: 46 Patients of enteric ileal perforation were studied during the period of 20 months, divided equally in 2 groups, Group A (loop ileostomy) and Group B (primary repair). An increased rate of post-operative complications was seen in Group B (primary repair) when compared with Group A (loop ileostomy) with 21.74% patients landed up in peritonitis secondary to leakage from primary repair and 17.39% ended up with controlled feacal fistula formation. Mortality rate was twice higher in Group B (primary repair) when compared with Group A (loop ileostomy). A ratio of 1:2.75 days was observed between hospital stay of Group A (loop ileostomy) to Group B (primary repair). Conclusion: Enteric ileal perforation still represents a disastrous complication of enteric fever and constitutes a good number of patients presenting in surgical emergency with acute abdomen. Exteriorization of perforation in the form of loop ileostomy is more appropriate option for such patients as compared to primary repair of the perforation when compared in terms of post-operative complications, hospital stay and mortality rate.