A Comparative Study between the Outcome of Primary Repair versus Loop Ileostomy in Traumatic and Non traumatic Ileal Perforation

Abstract

Introduction: Ileal perforation 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: The study was conducted in department of surgery LLR hospital, Kanpur. One hundred ten patients, fulfilling the including criteria, admitted to Surgical Emergency department were taken up for emergency surgery. The surgical management was done as primary repair (group A) and loop ileostomy (group B). The patients were assigned into two groups by even and odd method. Results: An increased rate of postoperative complications was seen in group B when compared with group A. In group A, 4 (9.09%) patients landed up in peritonitis secondary to leakage from primary repair requiring reoperation. In group B, 22 (39.29%) patients developed wound infection, 12 (21.43%) burst abdomen and 2 (3.57%) retraction of ileostomy. Mortality in primary repair was 3 (6.81%) and in loop ileostomy was 5 (8.9%). Conclusion: Patients presenting within 48 hours of ileal perforation, primary repair is better than loop ileostomy.