Role of enteric fever in ileal perforations: An overstated problem in tropics?

Capoor,; Nair, Deepthi; Chintamani,; Khanna, Jotinder; Aggarwal, Praveen; Bhatnagar, Divya

doi:10.4103/0255-0857.38859

Cited by 9 publications

(1 citation statement)

References 15 publications

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“…In our study, we therefore relied on the histopathological (HP) confirmation of enteric aetiology of the ileal perforation. We calculated sensitivity and specificity of two widely used serological tests – Widal and Typhidot against HP positive cases with clinical suspicion [11–13]. Sensitivity and specificity of Widal was comparable with other studies in this region.…”

Section: Discussionmentioning

confidence: 93%

Validation of the use of POSSUM score in enteric perforation peritonitis - results of a prospective study

Kumar¹,

Gupta²,

Chaudhary³

et al. 2011

Pan Afr Med Jrnl

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IntroductionThe objective of the study was to present our last 5-years experience of peritonitis and validate POSSUM score in predicting mortality and morbidity in patients of enteric perforation (EP) peritonitis.MethodsData was collected prospectively for all peritonitis cases admitted in single surgical unit from January 2005 to December 2009. Parameters for calculating POSSUM were also retrieved; in these patients, O:E (Observed vs. Expected) ratio of mortality and morbidity were estimated after calculating predicted mortality and morbidity by exponential regression equations.Results887 patients with peritonitis were admitted and treated in this unit during the 5 years of study period. Duodenal (n=431; 48%) followed by ileal (n=380; 42.8%) perforations were the commonest. Mean age of the patients was 34 years and 86% were males. Mean delay in presentation was 78.5 hrs. Mean duration of hospital and ICU stay was 13 and 7.2 days. Postoperative complications were seen in 481 (54%) patients, and 90 (10%) patients died. POSSUM scores and predicted mortality/morbidity were calculated in 380 patients of ileal perforation peritonitis; O:E ratio of mortality and morbidity were 0.47 and 0.85 in these patients.ConclusionPOSSUM and P-POSSUM are accurate tools for predicting morbidity and mortality respectively in EP patients. Though they may sometime over or under predict morbidity as well as mortality.

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Section: Discussionmentioning

confidence: 93%

Validation of the use of POSSUM score in enteric perforation peritonitis - results of a prospective study

Kumar¹,

Gupta²,

Chaudhary³

et al. 2011

Pan Afr Med Jrnl

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Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

Yadav

Garg

2012

Indian J Surg

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Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well in India. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counterpart. This study was conducted at Hindu Rao Hospital, Municipal Corporation of Delhi, New Delhi, India, designed to highlight the spectrum of perforation peritonitis in the eastern countries and to improve its outcome. This prospective study included 77 consecutive patients of perforation peritonitis studied in terms of clinical presentations, causes, site of perforation, surgical treatment, postoperative complications, and mortality at Hindu Rao Hospital, Delhi, from March 1, 2011 to December 1, 2011, over a period of 8 months. All patients were resuscitated and underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. The most common cause of perforation peritonitis noticed in our series was perforated duodenal ulcer (26.4 %) and ileal typhoid perforation (26.4 %), each followed by small bowel tuberculosis (10.3 %) and stomach perforation (9.2 %), perforation due to acute appendicitis (5 %). The highest number of perforations was seen in ileum (39.1 %), duodenum (26.4 %), stomach (11.5 %), appendix (3.5 %), jejunum (4.6 %), and colon (3.5 %). Overall mortality was 13 %. The spectrum of perforation peritonitis in India continuously differs from western countries. The highest number of perforations was noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. The most common cause of perforation peritonitis was perforated duodenal ulcer and small bowel typhoid perforation followed by typhoid perforation. Large bowel perforations and malignant perforations were least common in our setup.

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Wound Outcome Following Primary and Delayed Primary Skin Closure Techniques After Laparotomy for Non-Traumatic Ileal Perforation: a Randomized Clinical Trial

et al. 2016

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To study the effect of primary and delayed primary closure of skin incision on wound outcome in patients with non-traumatic ileal perforation, 68 patients of ileal perforation were studied in a prospective randomized clinical trial. Patients fulfilling inclusion criteria were divided into ileostomy and non-ileostomy groups, both of which were then randomized into two subgroups each depending on whether skin was closed primarily or in a delayed primary manner. Wound infection and dehiscence were the main outcome parameters studied. The data collected was analyzed using appropriate statistical tools taking significant value at 5 %. Most patients were 21-30 years of age. Male:female ratio was 3.2:1. The overall incidence of wound infection was 63 %. Wound infection was strongly associated with the incidence of superficial wound dehiscence and total wound dehiscence that were 11.76 and 47 %, respectively. Mortality was 10.3 %. Methodology of wound closure has no significant impact on incidence of wound infection, wound dehiscence, and mortality, although the onset of wound complications is significantly delayed with delayed primary closure of the skin.

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Role of enteric fever in ileal perforations: An overstated problem in tropics?

Cited by 9 publications

References 15 publications

Validation of the use of POSSUM score in enteric perforation peritonitis - results of a prospective study

Validation of the use of POSSUM score in enteric perforation peritonitis - results of a prospective study

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

Wound Outcome Following Primary and Delayed Primary Skin Closure Techniques After Laparotomy for Non-Traumatic Ileal Perforation: a Randomized Clinical Trial

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