Final outcome after Laproscopic interventional procedures in Enteric perforations with Peritonitis

Rajiv Kundu, MD. Jeewan Hospital,Jawalamukhi

Introduction: Typhoid fever is an endemic disease in India & other tropical countries. The term enteric includes both typhoid & paratyphoid fever  and is caused by Salmonella typhi & Paratyphi A,B&C. Various different types of procedures were advocated by different authors but still Enteric perforation has a high rate of morbidity & mortality in a open porocedure as compared to Laproscopic Exploration & repair.Materials & Methods: This study was conducted at Jeewan hospitals,Jawalamukhi,India between January 2013-January 2015.

Materials & Methods: This Study was conducted for a period of 2 years & the aim of the study was to compare all different types of approach in Enteric perforation surgery by Laproscopic intervension  in 40 patients.The prospective study group was kept on regular follow up for the next 6 months & the diversion ileostomy group was called in next 6-8 months for closure.The various procedures were compared using various stastical methods like Z test(test of proportion),&t test.

Results: In our Study the age of the patient ranged from 17 to 75 years,M:F ratio was 4.17:1.Fever & abdominal pain was present in all the cases. Leucopenia<4000/ was present in majority.abdominal distension.In this study perforation occurred in 1st week of illness in 57% of the patients.

Conclusion: Typhoid fever perforation remains a Major health problem in developing countries & early Laproscopic intervention is the best treatment option by consencus.

Matted bowel loops & gut oedema & inflammation if present ,resection & anastomosis should be avoided & diversion should be considered.

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