Operative management of typhoid perforation in children.

Nine children admitted with typhoid perforation of the ileum underwent a modified ileostomy procedure. The following conclusions were drawn: 1. X-rays do not help in diagnosis in the majority of cases. 2. Blood urea is raised in almost all cases and vigorous attempts should be made to bring its level to normal before operation. 3. Leukopenia does not exist in patients with typhoid perforation; leukocytosis is the usual finding. A positive Widal test is not generally found in these cases and positive blood cultures should not be expected. 4. Ileostomy through the site of perforation, as described, is a simple, safe and short operation in a critically ill patient with a necrotic bowel. Also, resuscitative drugs are not needed.