Saleh Allahbachani Memon, Gul Mohammad Shaikh, Mushtaq Abbasi.
Management of typhoid Enteric perforation in children : two layered closure vs ileostomy.
Pak J Surg Jan ;22(2):183-4.

Objective: To evaluate the outcome of the management of Typhoid Enteric Perforation in children with two different surgical techniques in our setting. Design & Duration: Comparative study from May 1998 to April 2005. Setting: Paediatric Surgery Units at Liaquat University of Medical and Health Sciences, Jamshoro; Isra University Hospital, Hyderabad and Dogar General Hospital, Tando Adam. Patients: All children who presented in emergency with Typhoid perforation of the gut. Methodology: In all the patients a detailed history was taken, and thorough examination and investigations perfor- med. The patients were resuscitated and operated. In half the patients the perforation was closed in two layers - Group-A, while in the remaining half an ileostomy was made - Group-B. The abdomen was closed after thorough peritoneal toilet and inserting drains. Results: A total number of 60 patients was seen with an age range from 1-12 years, mean seven years. Male children out-numbered female patients by a ratio of 2:1. Following surgery complications were seen in 10 (33.3%) cases of Group-A and 23 (76.7%) cases of Group-B. Conclusion: Early surgical intervention with a two-layer closure of the perforation is associated with decreased morbidity and mortality.

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