Perforation of the terminal ileum. A review of 38 cases

Dickson, J. A. S.; Cole, G. J.

doi:10.1002/bjs.1800511207

Cited by 63 publications

(42 citation statements)

References 5 publications

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“…reported 33% incidence in the second week of fever. 6,9,16,24 Our findings are nearly similar to those studies. Our study shows that patients who perforate during the 1st two weeks of the illness appear to have a better prognosis.…”

Section: Time Interval Of Perforationsupporting

confidence: 92%

Clinical study of typhoid ileal perforation and determination of preferred operative procedure in its management in Gandhi medical college and associated Hamidia hospital of Madhya Pradesh, India

et al. 2017

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Background: To analyze clinical and operative findings in typhoid ileal perforation and determining preferred operative procedure.Methods: All clinically suspected typhoid ileal perforation is classified into three categories depending on history, clinical and intraoperative findings (CAT I, CAT II, CAT III). All patients undergone surgical repair. Patient outcome in terms of complications, morbidity and mortality were compared to define the best procedure for Typhoid ileal perforationResults: Out of 105 patients, majorities were less than 30 years and were males (4:1). Most common presentation being pain abdomen (100%), followed by fever (85.71%) while signs of peritonitis are present in all patients (100%) and majority patients had septicemia (77.14%) (TLC count >11,000 or <4,000) on presentation. 82 (78.09%) patients were Widal positive. Among CAT I (n=47), majority require primary repair (n=27; 57.44%) followed by resection anastomosis (n=14; 29.78%) and ileostomy (n=5; 10.63%) while among CAT II (n=38), majority require ileostomy (n=12; 31.57%) followed by resection anastomosis (n=5; 13.5%), whereas in CAT III (n=20), most patients require Ileostomy (n=14; 70%). Overall complications are more with CAT III (n=12; 60%) compared to CAT I (n=08; 17%) and CAT II (n=10; 26.31%) (p<0.001). Wound infection being most common complication (n=24; 22.85%), while fecal fistula more common with resection anastomosis (n=5; 21.73%) followed by primary repair (n=7; 14.89%). Mortality maximum with CAT III patients (n=6; 30%) (p<0.05). Stoma related complications mostly seen in CAT III. Among CAT II, two patients (5.2%) develop intra-abdominal abscess and two patients (5.2%) undergone stoma revision.Conclusions: Primary repair and resection anastomosis are safer in CAT I while ileostomy is safer surgery in CAT III and CAT II. Resection anastomosis should be avoided in higher categories in fear of fecal fistula and related complications.

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Section: Time Interval Of Perforationsupporting

confidence: 92%

Clinical study of typhoid ileal perforation and determination of preferred operative procedure in its management in Gandhi medical college and associated Hamidia hospital of Madhya Pradesh, India

et al. 2017

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“…4 Butler found the overall mortality rate to be 70% with medical treatment and 26% with surgery. 6,7 Early prognostic evaluation is necessary to select high risk patients for more aggressive therapeutic procedures such as radical debridement, lavage systems, open management, and planned reoperations.…”

Section: Resultsmentioning

confidence: 99%

Prognostication of Perforation Peritonitis Cases Using Jabalpur Peritonitis Index

Singh¹,

Sharma²,

Hans³

et al. 2017

Int. J. Curr. Res. Med. Sci.

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“…Operative mortality was 0%. Dickson and Cole (1964). [15] reported 38 cases of ileum perforation in which 22 patients died at operation.…”

Section: Morbidity and Mortality In Enteric Perforationmentioning

confidence: 99%

Study of Predictive Ability of Modified Apache Ii Score to Prognosticate the Outcome and Severity of Generalized Peritonitis Secondary to Typhoid Ileal Perforation

Khorwal¹,

Yadav²,

Joshi³

et al. 2015

jemds

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Peritonitis (Peritoneal inflammation) may be primary, secondary or tertiary. Typhoid ileal perforation lead to secondary peritonitis that is a life threatening condition. Assessing the severity of peritonitis is important step in determining the proper treatment plan. AIM: This study is aimed to assess the ability of modified APACHE II (Acute Physiology and Chronic Health Evaluation II) score to correctly assess the severity of generalized peritonitis secondary to ileal perforation. MATERIALS AND METHODS: 100 patients of peritonitis secondary to ileal perforation were chosen in a one year period and were applied modified APACHE II score to assess the severity and outcome. RESULTS: Most of perforation occurred in 2nd and 3rd decade (65%). APACHE II score ranged from 1 to 21. Most of patients had < 9 score. Higher APACHE II score was associated with increased mortality. Morbidity was also accurately predicted by APACHE II score. CONCLUSION: Typhoid ileal perforation is still a common health problem causing high mortality (11%). Compared to mortality, morbidity was less accurately predicted by APACHE II score, and more number of the patients developed more complication in higher APACHE II score group. HOW TO CITE THIS ARTICLE:

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Perforation of the terminal ileum. A review of 38 cases

Cited by 63 publications

References 5 publications

Clinical study of typhoid ileal perforation and determination of preferred operative procedure in its management in Gandhi medical college and associated Hamidia hospital of Madhya Pradesh, India

Clinical study of typhoid ileal perforation and determination of preferred operative procedure in its management in Gandhi medical college and associated Hamidia hospital of Madhya Pradesh, India

Prognostication of Perforation Peritonitis Cases Using Jabalpur Peritonitis Index

Study of Predictive Ability of Modified Apache Ii Score to Prognosticate the Outcome and Severity of Generalized Peritonitis Secondary to Typhoid Ileal Perforation

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