Skip to main content
Log in

Comparative Study of Free Omental Sheet Graft and Other Operative Procedures of Enteric Perforation Repair

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background/Aim

In developing countries, enteric perforation due to typhoid continues to have very high morbidity and mortality rates irrespective of the type of operative procedure performed. The aim of the present study was to evaluate the effectiveness of a free omental sheet graft in perforated typhoid enteritis, in comparison to other methods of enteric perforation repair in terms of decreased morbidity, mortality and cost-effectiveness.

Method

A non-randomized study of 114 patients with enteric perforations was carried out over a period of 4.5 years. The study was divided in two groups; group I includes 38 cases in which a free omental sheet graft was used in typhoid enteritis with perforation and group II includes 76 cases in which other surgical procedures for enteric perforation repair were used. The outcomes were measured in relation to postoperative complications and mortality.

Results

The incidence of complications including faecal fistula was 2.6 % in group I (free omental sheet graft group) versus 32.89 % in group II. The mortality rate of 2.6 % was also lower in group I versus 19.7 % in group II.

Conclusion

This study concludes that the use of free omental sheet graft on typhoid enteric perforation site is effective in lowering the repair leak rate and thereby decreases the morbidity and mortality associated with these procedures. By lowering the complication rates, it also entails reduction in financial burden.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kouame J, Kouadio L, Turquin HT. Typhoid ileal perforation: surgical experience of 64 cases. Acta Chir Belg 2004; 104: 445–7.

    CAS  PubMed  Google Scholar 

  2. Rehman A. Spontaneous ileal perforation: an experience of 33 cases. J Post Grad Med Inst 2003; 17: 105–10

    Google Scholar 

  3. Singh KP, Singh K, Kohli JS. Choice of surgical procedure in typhoid perforation: experience of 42 cases. J Indian Med Assoc. 1991;89:255–6

    CAS  PubMed  Google Scholar 

  4. Olurin EO, Ajavi OO, Bohrer SP. Typhoid perforations. J Roy Coll Surg Edinb. 1972; 17:353–63.

    CAS  PubMed  Google Scholar 

  5. Beniwal US, Jindal D, Sharma J, Jam S, Shyam G: Comparative study of operative procedures in typhoid perforation. Indian J. Surg. 2003; 65: 172–7.

    Google Scholar 

  6. Adensunkanni AR, Desunkan MI, Ajao OG. The prognostic factors in typhoid ileal perforation: a prospective study of 50 patients. J R Coll Surg Edin. 1997; 42:395–9.

    Google Scholar 

  7. Roberto Caronna et al.: Comparative analysis of primary repair vs resection and anastomosis, with laparostomy, in management of typhoid intestinal perforation: results of a rural hospital in northwestern Benin. BMC Gastroenterology 2013 13:102. doi:10.1186/1471-230X-13-102

    Article  Google Scholar 

  8. Azari et al (2012) Effect of autologous omental free graft on wound healing process in experimental cervical oesophagus incision in dog: short term preliminary histopathological study. Comparative Clinical Pathology 21(5):559–563.

  9. Talwar S., Sharma R.K., Mittal D.K., Prasad P.: Typhoid enteric perforation. Aust. N.Z.J. Surg. 1997 Jun; 67(6): 351–3.

  10. Husain M, Khan RN, Rehmani B, Haris H. Omental patch technique for the ileal perforation secondary to typhoid fever. Saudi J Gastroenterol 2011; 17:208–211.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Eggleston FC, Santoshi B. Singh CM.: Typhoid perforation of bowel. Ann. Surg. 1979; 190: 31–5

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Amit Singh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Singh, A., Gora, N., Soni, M.L. et al. Comparative Study of Free Omental Sheet Graft and Other Operative Procedures of Enteric Perforation Repair. J Gastrointest Surg 18, 751–756 (2014). https://doi.org/10.1007/s11605-014-2464-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-014-2464-x

Keywords

Navigation