Typhoid perforation of the ileum in children.

Since 1974, 59 children with typhoid perforation of the ileum were studied prospectively using two protocols. In the first 36 cases a temporary total bypass of the terminal ileum was done (end-to-side ileotransverse colostomy) and several weeks later the intestinal continuity was restored (end-to-end ileoileostomy). The second protocol consisted, in 23 cases, of a partial bypass of the terminal ileum (one stage lateral tube ileostomy). Of the first group 10 died (27.7%). There was no reperforations or fistulae in this group. Of the 26 lateral tube ileostomies 8 died (34.8%). There was one reperforation and 4 fistula in this group. The combined mortality was 30.5%. Complications are presented as well as different methods of treatment. The author believes that a bypass operation with good medical supportive treatment, including total parenteral alimentation, will improve results.