[Surgical strategy for perforating typhoid ulcers]

The authors share their experiences with operative treatment for perforation of typhoid ulcers in 15 patients. The dissection of ulcerous infiltrate followed by simple suturing was fulfilled in 4 out of these patients against the background of diffuse purulent peritonitis. All the patients died. So, in order to reduce lethality in the following patients we either fulfilled resection of the gut within the limits of not involved tissues with ileostomy if the patient had diffuse purulent peritonitis or made primary interintestinal anastomosis in cases without it. In both cases a microirrigator was introduced in the small intestine mesentery for administration of antibiotics at the postoperative period. It allowed to make lethality lower.