A pilot study on the role of T-tube in typhoid ileal perforation in children.
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.
Pandey
Anand
A
Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India.
Kumar
V
V
Gangopadhyay
Ajay N
AN
Upadhyaya
Vijai D
VD
Srivastava
A
A
Singh
Ram B
RB
D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D007077:Ileal Diseases / Q000382:microbiology* / Q000473:pathology / Q000601:surgery*; D007081:Ileostomy / Q000295:instrumentation*; D007416:Intestinal Perforation / Q000382:microbiology* / Q000473:pathology / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome; D014435:Typhoid Fever / Q000150:complications* / Q000175:diagnosis / Q000628:therapy