Title: Protective Ileostomy in Ileal Perforation and Its Outcome Compared to Primary Repair
Authors: Dr J.Ramanaiah, Dr Chilumula Pavan Kumar, Dr Rajesh.Indla
DOI: https://dx.doi.org/10.18535/jmscr/v7i3.225
Abstract
A hospital based single blinded randomized study of 50 patients admitted to GMC&GGH,KADAPA with ileal perforation (diagnosed per-operatively) during the period of November 2016 to November 2018. All the 50 patients of ileal perforation were divided into two groups on consecutive sampling basis: Group A (primary repair with protective ileostomy and Group B (only primary repair). Detailed data of each patient including presentation, operative findings, procedures performed, postoperative outcome and HPE was entered on a specially designed proforma. The main outcome measures found significant were postoperative complication, hospital stay, psychological impact and mortality.
Conclusion: The construction of a temporary loop ileostomy to provide defunctioning for repair of ileal perforation reduces the incidence of fatal complication like faecal fistula.
Defunctioning ilestomy is a good option and life saving procedure.
Keywords: Protective Ileostomy; Faecal fistula; Ileal perforation; Primary closure; End-to-end anastomosis.
References
- Faisal Ghani Siddiqui, Jan Mohammed Shaikh, Nadul Ghani Soomro, Karim Bux, Syed Asad Outcome of ileostomy in the management of ileal perforation. JLUMHS 2008 Sep-Dec.
- Rauf A Wani, Fazl Q Pany, Nadeem A Bhat, Fowzia Non-traumatic ileal perforation. World Journal of Emergency Surgery 2006;1:7.doi:10.1186/ 1749-7922-1-7.
- Karmakar SR, Dwivedi, Bhalerao Perforations of terminal ileum. Indian journal of surgery 1972;34:422-6.
- Abdul Ghaffar Ansari, Syed Qaiser Hussain nagvi, Ali Akbar Ghumrao, Abdul Hakeem Management of typhoid ileal perforation: a surgical experience of 44 cases. Gomal Journal of Medical Sciences 2009 Jan- Jun;7(127):1.
- Chowdhury JUA, Iftekhar MH, Shaheed Development of an ideal operative procedure in typhoid perforation management. The Orion Medical Journal 2010 Jan;33(1):716-7.
- Shaukatali, Typhoid perforation; primary closure vs ileostomy. Professional Med J 2006 Jun;13(2):269-73.
- Ambreen Muneer, Razaque A Shaikh, Gulshan Ara Shaikh, Ali G Various complications in ileostomy construction. World Applied Sciences Journal 2007;2(3):190-3.
- Muhammad Sher-uz-Zaman, Fawad Hameed, Sheikh Atiq-ur-Rehma, Younis Loop ileostomy; complications in cases of enteric perforation. Professional Med Journal 2011 Apr-Jun; 18(2):222-7.
- Tariq Farooq, Mohammed Umar Rashid, Muhammed Faisal Bilal Lodhi. Enteric ileal perforation primary repair versus loop ileostomy. APMC 2011 Jan-Jun;5(1).