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Dr Abdul Malik Magsi, Dr Mazhar Iqbal, Dr Mariam Malik, Dr Munazza Shamim, Dr Sidra Khan, Dr Sughra Parveen, Dr Muhammad Iqbal Khan


Objective: To find out frequency, presentation and outcome of typhoid ileal perforation peritonitis. Place and duration of study: Conducted in ward 3-JPMC from October 2016 to October 2018. Study design: Observational description study. Methodology: All patients above 12 years of the age both male and female who were diagnosed as peritonitis were included in study, peritonitis due to typhoid perforation of ileum were studied in detail in terms of age, sex, presentation, gas under diaphragm, operative findings, lab investigations like Typhi dot test and blood culture. Post-operative complication and mortality were recorded. Results were analyzed with SPSS version 24. Results: Typhoid ileal perforation was leading cause of acute peritonitis (32.38%), then duodenal ulcer perforation (26.66%), rupture appendix 18.09%, TB intestine perforation 12.38%, gangrene gut 4.76% rupture liver abscess 1.90%, rupture tumor 1.9% and rupture gall bladder 1.9%. Male was predominantly involved. Common age was 21-40 years, majority of patients presented with history of 3-5 days of fever (95.59%). All patients had signs of peritonitis, 76.46%. Patients had signs of peritonitis and 76.46% of patients had gas under diaphragm. 36.23% presented with in 24 hour, 24.47% in 48 hours, 24.47% patients presented in ER after 2 days with acute peritonitis. 97.05% patients had single perforation in gut. Primary closure of gut were made in 61.76% and ileostomy in 38.23%. Post-operative complications occurred in 55.88%. Burst abdomen in 11.76%, surgical site infection in 44.11% and mortality was zero. Conclusion: Typhoid ileal perforation is leading cause of peritonitis in our setup which is preventable disease by good hygienic condition and vaccination. Mortality and morbidity can be reduced by early surgical intervention. Key Words: Ileal perforation, typhoid fever, acute peritonitis, surgical intervention.


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