Home|Journals Follow on Twitter| Subscribe to List

Directory for Medical Articles
 

Open Access

Original Article

J Liaquat Uni Med Health Sci. 2008; 7(3): 168-172


Outcome of Ileostomy in the Management of Ileal Perforation

Faisal Ghani Siddiqui, Jan Mohammad Shaikh, Abdul Ghani Soomro, Karim Bux, Abdul Sattar Memon and Syed Asad Ali.

Abstract
OBJECTIVE: To evaluate the role of a defunctioning ileostomy in the prevention of morbidity
and mortality in patients with small bowel perforation.
DESIGN: A prospective randomized study.
PLACE AND DURATION OF STUDY: Department of Surgery, Liaquat University of Medical &
Health Sciences, Jamshoro / Hyderabad between October 2005 and September 2006.
SUBJECTS AND METHODS: Total 108 patients who underwent laparotomy for ileal perforation
were included.
RESULTS: There were 67 males and 41 females. The age of patients ranged from 15 to 72 years
with 80% of the patients being in age group of 17-70 years. Typhoid was the commonest cause
for ileal perforation which was seen in 69 (63.8%) patients, followed by intestinal tuberculosis
which was present in 23 (21.3%) patients. Out of a total of 108 patients, a proximal defunctioning
ileostomy was constructed to protect the primary repair or the intestinal anastomosis in 57
patients (group I). In the remaining 51 patients, primary repair or intestinal anastomosis was
done without a defunctioning ileostomy (group II). Two (3.5%) patients in group I and 7 (13.7%)
patients in group II died postoperatively. Six of the 51 patients in group II who underwent primary
closure of perforation or resection and end-to-end anastomosis without a defunctioning
ileostomy developed postoperative faecal fistula. None of the patients with defunctioning ileostomy
developed this complication.
CONCLUSION: We conclude that construction of a temporary ileostomy to provide defunctioning
for repair of ileostomy perforations reduce the incidence of fatal complications like faecal
fistula. Ileostomy, however, is associated with a number of ileostomy-specific complications.
We recommend that defunctioning ileostomy should be preferred over all other surgical options
in cases of ileal perforations.

Key words: Ileostomy. Faecal fistula. Ileal perforation. Primary closure. End-to-end anastomosis.



Share this Article


Advertisement
Progress in Orthopedic Science

SUBMIT YOUR ARTICLE NOW


ScopeMed.com
ScopeMed Home
Follow ScopeMed on Twitter
BiblioCAM
Author Tools
eJPort Journal Hosting
About ScopeMed
License Information
Terms & Conditions
Privacy Policy
Contact Us

The articles in Scopemed are open access articles licensed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
ScopeMed is a Database Service for Scientific Publications. Copyright ScopeMed Information Services.
Scopemed Buttons