Study of the Incidence of Ileosotmy Related Complications Following Typhoid Perforations in a Tertiary Care Hospital
Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 2
Abstract
Aim: Study the incidence of ileosotmy related complications following typhoid perforations in a tertiary care hospital Introduction: Fecal diversion is a procedure done to provide either permanent opening for evacuation of effluent, or a temporary diversion in order to protect distal anastomosis in presence of severe sepsis, or poor general condition. Most commonly done procedure for fecal diversion following typhoid perforation is ileosotmy. Deep knowledge of the possible complications is necessary to an early recognition: this is essential to reduce the related morbidity and to improve the acceptance of the stoma. In fact, ileostomy is often badly tolerated by the patient and a complication may even worsen the already poor quality of life. Materials and Methods: 67 patients of typhoid perforation peritonitis admitted in surgical wards of, S.G.M. Hospital Associated with S.S. Medical College, Rewa (M.P.) from July 2009 to June 2010 were included in the study. After resuscitation, patients were subjected to laparotomy and depending upon the condition perforation was either repaired primarily or ileostomy was made. Postoperatively peristomal area was cleaned with water, and zinc + Vaseline paste was applied to prevent any skin irritation/excoriation from ileostomy effluent. Patients and attendant were explained about stomal and peristomal care. Complications were noted during hospitalization and during follow up. Most patients accepted ileostomy well and after they fully understood ileostomy care and were satisfied regarding their functioning and care of stoma, were discharged. Patients were called on monthly basis for follow-up and to assess the function of stoma and the complications associated with it. During the follow-up patients with poor nutrition status, anemia, poor weight gain were admitted and nutritional status was corrected. Results: Ileostomy prolapse was the main stomal complication i.e. 7.27% followed by retraction 9.10%; while in peristomal complication, peristomal dermatitis was the most common complication 40.0% followed by skin excoriation i.e.30.90%.
Authors and Affiliations
Dr Yogesh Kailasia
Keywords
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