Evaluation of best surgical procedures in typhoid perforation--an experience of 60 cases

The results of treatment of 60 cases of typhoid perforation were reviewed over a period of 4.5 years. Closure of the perforation was the method of treatment in 28 (46.66%) cases and closure of the perforation with side-to-side ileotransverse anastomosis was done in 32 (53.33%) cases. Faecal fistula was the most severe post-operative complication following simple closure of the perforation, causing death in all patients and leading to a 25% mortality in those treated by this technique. No fistula was found following closure of the perforation with side-to-side ileotransverse anastomosis, leading to a much lower mortality of 6.22%. The overall mortality in this series was 15%. Apart from toxaemia, surgical failure was the main contributory factor to such a high mortality. In this series, closure of the perforation with side-to-side ileotransverse anastomosis was the better surgical procedure.