Management of a single typhoid perforation: a comparative study of simple closure and wedge resection

ABSTRACT

Typhoid enteric perforation is a common surgical problem in our country and various methods of its treatment are unsatisfactory. 1. To compare the results of simple closure and wedge resection. 2. To evaluate and compare the post-operative complication. DESIGN: Prospective study SETTING: Bahawal Victoria Hospital, Bahawalpur. PERIOD June 1994 to March 1996. PATIENTS 49 Laparotomy proven patients of single typhoid perforation. METHODS: Sequentially one patient was treated by simple closure and other by wedge resection. Repair failure, intestinal fistula, burst abdomen, superficial wound infection and intra-peritoneal abscess formation were compared following these two procedures. Complications after simple closure were wound infection 33%, leakage from repair 21%, wound dehiscence 37% and residual abscess 25% as compared to wedge resection where these complications were 8%, 4%, 4% and 8% respectively. CONCLUSIONS: Wedge resection is superior to simple closure and is recommended as the procedure of choice in solitary typhoid perforation