Abstract
Background
Ileostomy is usually performed for patients of typhoid intestinal perforation with poor general condition, but it is associated with significant morbidity. We have used the T-tube in such patients as an alternative to ileostomy.
Methods
This is a prospective evaluation of a cohort of children with proven typhoid intestinal perforation. Patients with multiple perforations and poor general condition were managed with a T-tube inserted into the bowel lumen after closing all distal perforations (group 3). They were compared with patients who had primary closure of perforation (group 1) or bowel resection (group 2) to determine the efficacy of the use of T-tube.
Results
The total number of patients for groups 1, 2, and 3 was 51, 4, and 12 (n = 67). The mean number of perforations for the three groups was 1, 3.5 ± 0.58, and 4.25 ± 0.97. The operation time for the three groups was 37.29 ± 3.24, 59.25 ± 3.09, and 59.17 ± 4.17 minutes, respectively. The T-tube was removed after 13.17 days. The mean duration of fistula at T-tube site to heal was 8.58 ± 2.11 days. The overall follow-up period was 10.94 ± 1.15 months and none of the patients with T-tube placement had features of intestinal obstruction.
Conclusions
In children with multiple typhoid intestinal perforations and poor general condition, the use of T-tube may be an effective management option.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Chang YT, Lin JY, Huang YS (2006) Typhoid colonic perforation in childhood: a ten-year experience. World J Surg 30:242–247
Onen A, Dokucu AI, Cigdem MK, Ozturk H, Otcu S (2002) Yucesan S (2002) Factors effecting morbidity in typhoid intestinal perforation in children. Pediatr Surg Int 18:696–700
Atamanalp SS, Aydinli B, Ozturk G, Oren D, Basoglu M, Yildirgan MI (2007) Typhoid intestinal perforations: twenty-six year experience. World J Surg 31:1883–1888
Gauderer MWL (2006) Stomas of the small and large intestine. In: Grosfeld JL, O’Neill JA Jr, Fonkalsrud EW, Coran AG (eds) Pediatric surgery, 6th edn. Mosby Elsevier, pp 1479–1493
Ameh EA (1999) Typhoid ileal perforation in children: a scourge in developing countries. Ann Trop Pediatr 19:267–272
Parry CM, Hien TT, Dougan G (2002) Typhoid fever. N Engl J Med 347:1770–1782
Hosoglu S, Aldemir M, Akalin S, Geyik MF, Tacyildiz IH, Loeb M (2004) Risk factors for enteric perforation in patients with typhoid fever. Am J Epidemiol 160:46–50
Rehbein F, Halsband H (1968) A double-tube technique for the treatment of meconium ileus and small bowel atresia. J Pediatr Surg 3:723–726
Harberg FJ, Senekjian EK, Pokorny WJ (1981) Treatment of uncomplicated meconium ileus via T-tube ileostomy. J Pediatr Surg 16:61–63
Mathai J, Sen S, Zachariah N, Chacko J, Thomas G (2003) Proximal Malecot vent in neonatal small-bowel anastomosis. Pediatr Surg Int 19:245–246
Hung WT, Tsai YW, Lu WT (1995) T-tube drainage for the treatment of high jejunal atresia. J Pediatr Surg 30:563–565
Asfar SK, Al-Sayer HM, Juma TH (2007) Exteriorized colon anastomosis for unprepared bowel: an alternative to routine colostomy. World J Gastroenterol 13:3215–3220
Rygl M, Pycha K, Strank Z, Skaba R, Brabec R, Snajdauf J (2007) T-tube ileostomy for intestinal perforation in extremely low birth weight neonates. Pediatr Surg Int 23:685–688
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pandey, A., Kumar, V., Gangopadhyay, A.N. et al. A Pilot Study on the Role of T-Tube in Typhoid Ileal Perforation in Children. World J Surg 32, 2607–2611 (2008). https://doi.org/10.1007/s00268-008-9746-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-008-9746-y