Outcomes of Primary Repair in Patients with Typhoid Ileal Perforation

Background: Typhoid fever is still a high burden disease in developing nations. Caused by infection with Salmonella typhi. Fecal flora is a risk source of this bacteria and the infection is routinely caused by ingestion of soiled food and water which is a major problem in developing countries. WHO reported >200,000 deaths due to typhoid fever in 2015. While in Pakistan the mortality rate has been reported to be 9.3/100,000 in overall population.Objective: To determine the outcomes of primary repair in patients of typhoid ileal perforation.Material and Methods: In present case series we included 170 adult patients of age 15-75 years of age, who presented with typhoid ileal perforation in Department of General Surgery Saidu Teaching Hospital within the period of 01-Jan-2018 to 31-Dec-2019. In all patients two-layer primary repair was done. Outcomes were noted in-terms of post-surgery wound infections, intra-abdominal collection, anastomotic leakage, wound dehiscence and in-hospital mortality.Results: Mean age of patients was 43.5±14.7 years. Out of 170 patients, 145 (85.2%) were men and 25 (14.8%) women. Mean duration of illness was 6.56±3.62 days. Wound infections were diagnosed in 49 (28.8%) patients, pneumonia in 22 (12.9%), intra-abdominal collection in 11 (6.5%), anastomotic leakage in 08 (4.7%) patients, wound dehiscence (burst abdomen) in 07 (4.1%) and 6 (3.5%) patients required ICU admission. In-hospital mortality occurred in 08 (4.7%) patients.Conclusion: Primary repair is an easy and safe technique of typhoid ileal perforation and has acceptable rate of post-operative complications.Keywords: Typhoid ileal perforation, primary repair.