Role of ileostomy in ileal perforation and its complications
Tóm tắt
Enteric perforations have been seen as a common problem in tropical countries. Over a period of time the trend of the enteric perforations, its treatment, disease progression and prognosis has changed.
The study of 75 cases of Enteric perforations treated and underwent ileostomy as a treatment modality between time period of May 2010 to July 2016 were included in the study. Patients having enteric perforations but did not undergo ileostomy were excluded. Traumatic ileal perforations were also excluded from the study. In the study conducted the commonest cause of Enteric fever was non-specific ileal perforations. Perforations occurred in second week after onset of fever with mean of 10.5 days. Perforation commonly occurred in second and third decade of life with 48% of patients between ages 11-30. The mean age of the patients was 33.72 years. Male preponderance with male to female ratio 5:1 was observed. Pneumoperitoneum in chest and erect abdominal X-Ray was seen in 84% of the patients. Time between onset of pain and surgical intervention (Lag Period) was between 10 to 96 hours with mean of 43.44 hours. Single Ileal perforation was seen in 84% of the cases with 72% of the perforations being located within 30 cm from IC junction. Majority of the perforations were located within 60 cms from ICJ (96%). Nonspecific enteric perforation (48%) was the commonest cause of enteric perforation. Ileostomy as a treatment modality carried a mortality rate of 2.66%. Chest X-Ray is a useful diagnostic tool. Ileostomy closure carried an overall complication rate of 68%. Small bowel obstruction, wound infection and ECF were commonly seen complications. Small bowel obstruction occurred in 12% of cases and was managed conservatively.
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