| Autor: |
Divya, Radhakrishnan, M. S., K. Rojaramani, Reddy, Kanala Indrasena, Thirupathi, Sunku, Surya, Vidavaluru Sada, Prasad Reddy, K. Eswar, Siva Prasad, C. V., Varsha, K. Sri |
| Předmět: |
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| Zdroj: |
European Journal of Cardiovascular Medicine; 2024, Vol. 14 Issue 4, p269-279, 11p |
| Abstrakt: |
Introduction: Peritonitis due to Hollow viscus perforation is the commonest cause for the acute abdomen next to Acute appendicitis. It is the most common emergency surgery done for a case of acute abdomen. Among the cases of hollow viscus perforation Duodenal and Gastric perforations are the commonest, followed by Ileal, Appendicular, and large bowel. The incidence of Gastric perforation is on the rise followed by the Ileal perforation accounting for about 20% of total hollow viscus perforation. Among the causes for Enteric perforation, Typhoid ileal perforation is common. Aim: To study the Enteric Perforation due to Typhoid. Objectives: 1. To study the incidence of Ileal perforation in relation to age and sex. 2. To evaluate the mode of clinical presentation in patients with ileal perforation due to typhoid. 3. To study the management and outcome of patients with ileal perforation due to typhoid. Study Design: Prospective observational study. Study Population: All patients presenting to emergency and surgical OPD with symptoms of peritonitis (hollow viscus perforation). Materials And Methods: This study was done in the Department of General Surgery, SVRRGGH, Tirupathi. The materials for the study were collected from patients presenting to the surgical outpatient department and emergency with features of hollow viscus perforation during the period of December, 2020- December 2021 were included in the study. Inclusion Criteria: 1. Patients with age above 18 years present with features of hollow viscus perforation. 2. Patients with intraoperative findings of ileal perforation. 3. Patient who gave consent for emergency exploratory laparotomy. Exclusion Criteria: 1. Patients with the intraoperative finding of hollow viscus perforation other than ileal perforation. 2. Patients with cardiovascular, pulmonary disease. Observation And Results: This study shows the common etiology of Ileal perforation was Typhoid (Enteric fever) accounting for 83% followed by Tuberculosis 8%. The average age of presentation was between 20 and 40 years. There was a male preponderance with 70%. The majority of the cases accounting for 53% were seen during the 3rd and 4th week of the typhoid fever. The predominant symptoms were abdominal pain and vomiting. The most common sign elicited was guarding and rigidity in all cases 100%. The most reliable test that identified perforation was x-ray 100%. The biopsy culture of the perforated ulcer edge had yielded positive results of 73% when compared to blood culture and serum widal tests. All the perforations in the present study were found within 50cm of the terminal ileum. None were noted beyond 50 cm from the ileocecal junction, due to the presence of more Peyer’s patches in the terminal ileum. 77% of ileal perforations were single in number. The primary closure and peritoneal lavage were the procedure done in 70% of cases. Postoperative complications were seen in 37%. The most common complication encountered was the Wound infection accounting for 30% overall. The re-exploration rate was 6% done in 2 cases. The mortality in the present study was 6.66%. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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