RETROSPECTIVE ANALYSIS OF TYPHOID ILEAL PERFORATION IN CHILDREN

BACKGROUND: Objective of the study is to find out the most suitable procedure for surgicaltreatment of typhoid ileal perforation in children. It is a Descriptive retrospective study, conducted atDepartment of Pediatric surgery Lady Reading Hospital Peshawar from January 2012 to June 2014.MATERIALS AND METHODS: This study included all patients who had operative findings oftyphoid ileal perforation. All the patients were admitted at Pediatric Surgery Unit Lady ReadingHospital Peshawar, as emergency. A total of 78 patients were managed during the study period. Patientswere admitted, nasogastric tube was inserted, intravenous fluids and antibiotics in the form ofquinolones, metronidazole and gentamycin were administered. Informed consent from the parents wastaken in all cases. Surgical Procedure was tailored according to the peroperative findings. Data wasanalyzed using SPSS version 16.RESULTS: Out of 78 patients, 49(62.8%) were male and 29(37.1%) were female. The mean age ofpresentation was 10.4 years. Duration of symptoms ranged from 7 to 20 days. The commonestsymptoms observed were fever in 78(100%),pain abdomen 78(100%),abdominal distension28(35.89%)and vomiting in 51(65.38%).The choice of surgical procedure was done peroperativelydepending on the extent of contamination of peritoneal cavity and the general condition of the patient.Mean hospital stay was 8 days.CONCLUSION: Early presentation and referral to tertiary care hospital can improve the mortality andmorbidity in children with typhoid ileal perforation. All patients who underwent ileostomy recoveredwell and is the procedure of choice in patients who present late.KEY WORDS: Typhoid ileal perforation, surgical options, ileostomy.