Role of Ileostomy in Enteric Perforation.
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Date
2015-01
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Abstract
Introduction: Enteric perforations have been seen as a common problem in tropical countries. Over a period the trend of enteric
perforations has changed, its treatment, disease progression and prognosis.
Methods: The studies of 25 cases of ileal perforations treated and underwent an ileostomy as a treatment modality between
the periods of May 2010-August 2012 were included. Traumatic ileal perforations and ileal perforation without an ileostomy were
excluded from the study.
Results: In a study conducted commonest cause was Enteric fever in nonspecifi c ileal perforations. Perforation commonly
occurred in second and third decade of life with 48% of patients belongs to the age group between 11 and 30. The mean age
of the patients in the study was 33 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 and 96 h with the mean of 43.44 h. Single ileal perforations were seen in 84% of the cases with 72%
being located within 30 cm from ileocecal junction (ICJ). Majority were located within 60 cm from ICJ (96%).
Conclusions: A non-specifi c enteric perforation (60%) was the most common cause of ileal perforation. Ileostomy as a treatment
modality carried a mortality rate of 4%. Ileostomy closure an overall complication rate of 24%. Wound infection, small bowel
obstruction and enterocutaneous fi stula were commonly seen complications. 12% cases had small bowel obstruction managed
conservatively.
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Keywords
Crisis Intervention, Ileostomy, Pneumoperitoneum
Citation
Shah Shashikant, Gandhi Jenit P. Role of Ileostomy in Enteric Perforation. IJSS Journal of Surgery 2015 Jan-Feb; 1(1): 10-15.