COMMON CLINICAL OUTCOMES AFTER PRIMARY CLOSURE IN PATIENTS WITH TYPHOID ILEAL PERFORATIONS A DESCRIPTIVE CROSS SECTIONAL STUDY IN SURGICAL DEPARTMENT KHYBER TEACHING HOSPITAL PESHAWAR

Introduction: Ileal perforation accounts for major cause for obscure peritonitis. This contributes to high morbidity and
mortality in developing countries where medical facilities are not readily available. Enteric fever is endemic in the areas
where sanitation is poor in developing countries. Its serious complication is bowel perforation with terminal ileum as
the commonest perforation site. Tissue damage in Peyer’s patches results in ulceration, bleeding, necrosis, and, in
extreme cases, full-thickness perforation and is a major cause of perforation peritonitis.
Objective: To determine the frequency of common clinical outcomes after primary repair in patients presenting with
typhoid ileal perforations.
Materias and methods: This study was conducted in the in the Department of Surgery, Khyber Teaching Hospital,
Peshawar from April, 2012 to June, 2014. Through a Descriptive Cross Sectional Study Design, a total of 319 patients
presenting with ileal perforation due to typhoid fever were included in the study through a consecutive manner and
were subjected to primary closure of the defect and followed up to detect common clinical outcome.
Results: The mean age group of our sample was 34.9 + 16.2 years of which 72.1% were male and 27.9% were females.
After doing the primary closure, surgical site infection was observed in 38 (11.9%), wound dehiscence was observed
in 51 (16%) and post- operative death was observed in 26 (8.2%) of patients.
Conclusion: Typhoid ileal perforation is a common occurrence in our population and primary closure of the defect is
most commonly performed surgery for treatment. However, the frequency of adverse clinical outcome is still high and
further treatment strategies must be searched to reduce the burden of these complications.
Key Words: Typhoid Fever, Ileal Perforations, surgical site infection, wound dehiscence, mortality