%0 Journal Article
%T A Comparative Study between the Outcome of Primary Repair versus Loop Ileostomy in Ileal Perforation
%A Sushil Mittal
%A Harnam Singh
%A Anand Munghate
%A Gurpreet Singh
%A Anjna Garg
%A Jyoti Sharma
%J Surgery Research and Practice
%D 2014
%R 10.1155/2014/729018
%X Introduction. Ileal perforation peritonitis is a common surgical emergency in the Indian subcontinent and in tropical countries. It is reported to constitute the fifth common cause of abdominal emergencies due to high incidence of enteric fever and tuberculosis in these regions. Methods. Sixty proven cases of ileal perforation patients admitted to Surgical Emergency were taken up for emergency surgery. Randomisation was done by senior surgeons by picking up card from both the groups. The surgical management was done as primary repair (group A) and loop ileostomy (group B). Results. An increased rate of postoperative complications was seen in group A when compared with group B with 6 (20%) patients landed up in peritonitis secondary to leakage from primary repair requiring reoperation as compared to 2 (6.67%) in ileostomy closure. A ratio of 1£¿:£¿1.51 days was observed between hospital stay of group A to group B. Conclusion. In cases of ileal perforation temporary defunctioning loop ileostomy plays an important role. We recommend that defunctioning ileostomy should be preferred over other surgical options in cases of ileal perforations. It should be recommended that ileostomy in these cases is only temporary and the extra cost and cost of management are not more than the price of life. 1. Introduction Gastrointestinal perforations have been surgical problem since the time immortal. Scientists have found evidence of gastrointestinal perforations in Egyptian mummies. Perforation is said to occur once a pathology which extends through the full thickness of the hollow viscus leading to peritoneal contamination with intraluminal contents. Perforation can occur anywhere in the gastrointestinal tract starting from oesophagus to the rectum [1]. Ileal perforation peritonitis is a common surgical emergency in the Indian subcontinent and in tropical countries. It is reported to constitute the fifth common cause of abdominal emergencies due to high incidence of enteric fever and tuberculosis in these regions. Despite the availability of modern diagnostic facilities and advances in treatment regimes, this disease has an abrupt onset and a rapid downhill course with a high mortality if not treated [2, 3]. Various causes of nontraumatic ileal perforation include bacterial infections (salmonella, yersinia, and tuberculosis), viral infections (cytomegalovirus, human immunodeficiency virus), fungal infection (histoplasma), parasitic infections (A. lumbricoides, E. vermicularis, and E. histolytica), and others (Wagener¡¯s granulomatous and drugs (Nonsteroidal
%U http://www.hindawi.com/journals/srp/2014/729018/