Utility of Distal Loopogram Prior to Post Typhoid Ileostomy Reversal

Abstract

The Distal loopogram assesses distal bowel health pre-stoma reversal. Yet, its benefits for typhoid perforation patients require further evaluation. Objective: To assess the utility of distal loopogram before the ileostomy stoma reversal in patients of typhoid perforation. Methods: A comparative, cross-sectional study was conducted upon a sample of 76 patients of both gender with age from 13 to 70 years and being operated for reversal of post-typhoid perforation loop ileostomy with or without distal loopogram study at Liaquat University Hospital Jamshoro and Hyderabad. Non-consenting patients and the patients with deranged kidney function or comorbid conditions in which contrast material is contraindicated or patients allergic to contrast agent or having tendency of atopy to any allergens like patients of bronchial asthma and those who lost to follow up were excluded from the sample. Results: The loopogram accurately predicted anastomotic leakage and mucocutaneous separation in all cases during surgery. Bowel stricture was predicted in 66.7% of cases, and peristomal dermatologic problems in 50%. This highlights the loopogram's utility in anticipating surgical challenges, especially for critical issues like anastomotic leakage and mucocutaneous separation. Conclusions: It was concluded that distal loopogram was valuable for assessing post-typhoid ileostomy reversal patients, offering detailed small intestine images for identifying complications and enhancing surgical planning, thus improving outcomes