G. Kishore Babu1, K. Lokesh2
INTRODUCTION
Ileal perforation is a common problem seen in tropical countries, the commonest cause being typhoid fever. In western countries the causes are malignancy, trauma and mechanical aetiology, in the order of frequency.1,2,3 Over the years a definite changing trend has been observed in ileal perforations both in terms of causes, treatment and prognosis. Better antibiotics, aggressive surgery and the elimination of conservative treatment, better preoperative and postoperative care have all significantly contributed to the improvement in patient outcome.4,5 But still cases of ileal perforation cause a significant morbidity and mortality that persists despite the significant changes in health care over the years.
AIMS AND OBJECTIVES
To study the aetiology, presentation, management outcome and the factors influencing prognosis and outcome in ileal perforations.
MATERIAL & METHODS
Study Setting
S. V. Medical College, Department of General Surgery, Tirupati.
Study Period
Patients attending S. V. Medical College, Department of General Surgery with perforation during the period from November 2012 to October 2015.
Inclusion Criteria
Patients between age group of more than 14 years presenting with pain abdomen and who are diagnosed to have ileal perforation in the intra operative period are selected.
Exclusion Criteria
Patients with peritonitis due to other causes like gastric, duodenum or large bowel perforation are excluded.
Study Method
The present study is a prospective study done on 28 patients of ileal perforation due to typhoid complication, nonspecific and traumatic perforations. History, clinical examination, investigations, operative findings, post-operative complications were recorded. In patients with non-traumatic perforations Widal test was done.
CONCLUSION
Typhoid fever and traumatic aetiology are the most common cause of Ileal perforation, followed by TB. Patients are more of male gender and are in reproductive age group. Widal serology is a useful test in the diagnosis of typhoid fever; histopathology is useful in the diagnosis of tubercular perforations. Ileal perforations have a higher morbidity rate. Traumatic perforations have a good outcome than other causes.
