Typhoid bowel perforation: Lessons learnt at shaikh zayed hospital, Lahore

ABSTRACT

This study comprises of 41 patients with typhoid perforation managed over a 4 years period at Department of Surgery, Shaikh Zayed Hospital Lahore. Peritonitis due to typhoid bowel perforation was the commonest cause observed in 33.5% cases. The disease is prevalent in rainy season commoner in males [2.11] and in the younger age group [mean age 27.8 years]. Twenty four% patients were resistant to chloramphenicol and presentation to the hospital after perforation was late [mean lag 3.5 days]. Quinolone derivatives have changed the management scenario in perforated typhoid enteritis. Defunctioning procedures [loop ileostomy, tube ileostomy, or end ileostomy] in patients with advanced sepsis and toxemia in typhoid enteric perforation are found safe with low morbidity [p < 0.05] and zero mortality. Inspite of late presentation, the overall mortality is low [9.7%] on account of better perioperative management of the patients