Typhoid ileal perforations: a study of 75 patients

ABSTRACT

The results of surgical treatment of 75 cases of typhoid ileal perforation are presented. Fifty-eight% of the patients were between 20 and 40 years of age. Seventy-five% of the patients were seen after an illness of 2-4 weeks. Most of the patients reported late to the hospital so upto 72% of the patients were explored 24 hours after the perforation occurred. At operation the peritoneal cavity was full of pus and small bowel contents. More than 85% of the perforations were located within 60cm from ileocecal valve. Only 16% patients had multiple perforations. Thirty-eight patients [50.7%] underwent simple closure of their perforations. Nineteen patients [25.3%], underwent wedge-excision of the ulcer and 2-layer closure and eighteen [24%] underwent exteriorization of the perforation as an ileostomy, mostly because of multiple perforations. Peritoneal toilet with warm saline was performed in all patients. The overall mortality was 12%. Chloramphenicol, genticyn and metronidazole were used in combination in all the patients. We recommended early limited surgery to improve results: