MANAGEMENT OF A SINGLE TYPHOID PERFO-RATION: A COMPARATIVE STUDY OF SIMPLE CLOSURE AND WEDGE RESECTION

Typhoid enteric perforation is a common surgical problem in our country and various methods of itstreatment are unsatisfactory. OBJECTIVES: 1. To compare the results of simple closure and wedge reaction.2. To evaluate and compare the post-operative complications. DESIGN: Prospective study SETTING:Bahawal Victoria hospital, Bahawalpur. PERIOD: June 1994 to March 1996. PATIENTS: 49 Laparotomyproven patients of single typhoid PERFORATIN. Methods: Sequentially one patient was treated b simpleclosure and other by wedge resection. Repair failure, intestinal fistula, burst abdomen, superficial woundinfection and intra-peritoneal abscess formation were compared following these two procedures. RESULTS:Complications after simple closure were wound infection 33%, leakage from repair 21% wound dehiscence37% and residual abscess 25% as compared to wedge resection where these complications were 8%, 4%,an4% and 8% respectively. Conclusions: Wedge resection is superior to simple closure and is recommendedas the procedure of choice in solitary typhoid perforation.