DOI: 10.36347/sjams.2017.v05i05.044

Pages: 1931-1937

Ileal perforation is a common surgical emergency in developing countries due to high incidence of enteric fever and tuberculosis in these regions. Despite the availability of modern diagnostic facilities and advanced treatment regime, this condition is still associated with high mortality and morbidity. Surgical approach is the standard treatment for ileal perforation and is the only successful modality. But the choice of procedure continues to be debated. This retrospective study is aimed at reviewing the role of temporary loop ileostomy in patients with ileal perforation. The study includes 56 cases of ileal perforation which were treated and underwent temporary loop ileostomy as a treatment modality from Jan 2015 to Feb 2017. Patients having ileal perforation but did not undergo ileostomy were excluded. In the study, the commonest cause of perforation was typhoid fever. Forty one (73.3%) patients were male and fifteen (26.7%) were female. Male to Female ratio is 3:1. Predominance of male patient noted. Most of the patient presented with abdominal pain, abdominal distension, nausea, vomiting, constipation and fever. Pneumoperitonium in chest and erect abdominal X-ray were seen in 52 cases (92.8%). Single ileal perforation was seen in 44 cases (78.5%). Of the cases the majority of ileal perforation located within 60cm of ileocaecal valve. Typhoid perforations are the most common cause of ileal perforation followed by tuberculosis. In case of ileal perforation temporary defunctioning loop ileostomy play important role. We recommended that defunctioning loop ileostomy should be preferred over other surgical procedures in case of ileal perforation where most of the patients present late with severe sepsis and generalised peritonitis.