Utility of Distal Loopogram Prior to Post Typhoid Ileostomy Reversal

Distal Loopogram for Typhoid Ileostomy Reversal

Authors

  • Ali Raza Liaquat University Hospital, Hyderabad/Jamshoro, Pakistan
  • Altaf Ahamd Talpur Department of General Surgery, Liaquat University of Medical and Health Sciences, Jamshoro,Pakistan
  • Shah Nawaz Khatti Department of General Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
  • Ahmad Hussain Agha Department of General Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
  • Mohammad Basil Rizvi Department of General Surgery, Avicenna Medical College and Hospital, Lahore, Pakistan
  • Zeeshan Ahmad Department of General Surgery, Rai Medical College, Surgodha, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v5i04.1511

Keywords:

Distal Loopogram, Ileostomy Reversal, Typhoid, Bowel Health

Abstract

The Distal loopogram assesses distal bowel health pre-stoma reversal. Yet, its benefits for typhoid perforation patients require further evaluation. Objective: To assess the utility of distal loopogram before the ileostomy stoma reversal in patients of typhoid perforation. Methods: A comparative, cross-sectional study was conducted upon a sample of 76 patients of both gender with age from 13 to 70 years and being operated for reversal of post-typhoid perforation loop ileostomy with or without distal loopogram study at Liaquat University Hospital Jamshoro and Hyderabad. Non-consenting patients and the patients with deranged kidney function or comorbid conditions in which contrast material is contraindicated or patients allergic to contrast agent or having tendency of atopy to any allergens like patients of bronchial asthma and those who lost to follow up were excluded from the sample. Results: The loopogram accurately predicted anastomotic leakage and mucocutaneous separation in all cases during surgery. Bowel stricture was predicted in 66.7% of cases, and peristomal dermatologic problems in 50%. This highlights the loopogram's utility in anticipating surgical challenges, especially for critical issues like anastomotic leakage and mucocutaneous separation. Conclusions: It was concluded that distal loopogram was valuable for assessing post-typhoid ileostomy reversal patients, offering detailed small intestine images for identifying complications and enhancing surgical planning, thus improving outcomes

References

Ahmed HN, Niaz MP, Amin MA, Khan MH, Parhar AB. Typhoid perforation still a common problem: situation in Pakistan in comparison to other countries of low human development. JPMA. The Journal of the Pakistan Medical Association. 2006 May; 56(5): 230-2.

Sharma AK, Sharma RK, Sharma SK, Sharma A, Soni D. Typhoid intestinal perforation: 24 perforations in one patient. Annals of Medical and Health Sciences Research. 2013; 3(1a): 41-3. doi: 10.4103/2141-9248.121220 DOI: https://doi.org/10.4103/2141-9248.121220

Azmatullah A, Qamar FN, Thaver D, Zaidi AK, Bhutta ZA. Systematic review of the global epidemiology, clinical and laboratory profile of enteric fever. Journal of Global Health. 2015 Dec; 5(2). doi: 10.7189/jogh.05.020407. DOI: https://doi.org/10.7189/jogh.05.020407

Das JK, Hasan R, Zafar A, Ahmed I, Ikram A, Nizamuddin S et al. Trends, associations, and antimicrobial resistance of Salmonella typhi and paratyphi in Pakistan. The American Journal of Tropical Medicine and Hygiene. 2018 Sep; 99(3): 48. doi: 10.4269/ajtmh.18-0145. DOI: https://doi.org/10.4269/ajtmh.18-0145

Verma H, Dev K, Pandey S, Gurawalia J, Marwah S. Temporary loop versus end ileostomy for faecal diversion in ileal perforation: a case matched study. Sri Lanka Journal of Surgery. 2016 Apr; 34(1). doi: 10.4038/sljs.v34i1.8233. DOI: https://doi.org/10.4038/sljs.v34i1.8233

Usang UE, Inyang AW, Nwachukwku IE, Emehute JD. Typhoid perforation in children: an unrelenting plague in developing countries. The Journal of Infection in Developing Countries. 2017 Oct; 11(10): 747-52. doi: 10.3855/jidc.9304. DOI: https://doi.org/10.3855/jidc.9304

Shah S and Gandhi JP. Role of ileostomy in enteric perforation. International Journal of Spine Surgery. 2015 Jan; 1(1): 10-5.

Ugochukwu AI, Amu OC, Nzegwu MA. Ileal perforation due to typhoid fever–review of operative management and outcome in an urban centre in Nigeria. International Journal of Surgery. 2013 Apr; 11(3): 218-22. doi: 10.1016/j.ijsu.2013.01.014. DOI: https://doi.org/10.1016/j.ijsu.2013.01.014

Žukauskienė V and Samalavičius NE. Early loop ileostomy closure: should we do it routinely? Lietuvos Chirurgija. 2013; 12(3): 152-5. doi: 10.15388/LietChirur.2013.3.1838 DOI: https://doi.org/10.15388/LietChirur.2013.3.1838

Khair G, Alhamarneh O, Avery J, Cast J, Gunn J, Monson JR et al. Routine use of gastrograffin enema prior to the reversal of a loop ileostomy. Digestive Surgery. 2007 Sep; 24(5): 338-41. doi: 10.1159/000107713. DOI: https://doi.org/10.1159/000107713

Ali SA, Soomro AG, Memon AS, Shaikh NA. Postoperative complications of reversal of loop ileostomy.Journal of Liaquat University of Medical & Health Sciences. 2009 Jan; 8(01): 23.

Udawat HS, Parihar S, Saxena P. Comprehensive study of ileostomy at a tertiary care medical college hospital. Journal of Evolution of Medical and Dental Sciences. 2016 Feb; 5(14): 659-64. doi: 10.14260/jemds/2016/151. DOI: https://doi.org/10.14260/jemds/2016/151

Kundagulwar G, Pai V, Saklani A. Role of distal loopogram before defunctioning stoma reversal-results from an Indian tertiary-care center. Cancer Therapy and Oncology International Journal. 2016; 555574. doi: 10.19080/CTOIJ.2016.01.555574. DOI: https://doi.org/10.19080/CTOIJ.2016.01.555574

Babakhanlou R, Larkin K, Hita AG, Stroh J, Yeung SC. Stoma-related complications and emergencies. International Journal of Emergency Medicine. 2022 Dec; 15(1): 17. doi: 10.1186/s12245-022-00421-9. DOI: https://doi.org/10.1186/s12245-022-00421-9

Kita Y, Mori S, Tanabe K, Baba K, Tanoue K, Idichi T et al. Clinical prospects for laparoscopic stoma closure of a temporary loop ileostomy: Initial experience and report. Asian Journal of Endoscopic Surgery. 2020 Oct; 13(4): 618-21. doi: 10.1111/ases.12790. DOI: https://doi.org/10.1111/ases.12790

Saini P, Gupta P, Sharma A, Agarwal N, Kaur N, Gupta A. Should routine contrast study be a norm before stoma reversal? A retrospective study of patients with temporary ileostomy. Tropical Doctor. 2013 Apr; 43(2): 57-61. doi: 10.1177/0049475513489827. DOI: https://doi.org/10.1177/0049475513489827

Goetz A, da Silva NP, Moser C, Agha A, Dendl LM, Stroszczynski C et al. linical value of contrast enema prior to ileostomy closure. RöFo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren. 2017 Sep; 189(9): 855-863. doi: 10.1055/s-0043-111598. DOI: https://doi.org/10.1055/s-0043-111598

Shah JN, Subedi N, Maharjan S. Stoma Reversal, a hospital based study of 32 cases. The Internet Journal of Surgery. 2009; 22(1). doi: 10.5580/19e8. DOI: https://doi.org/10.5580/19e8

Hussain A, Mahmood H, Nicholls J, El-Hasani S. Continuous figure-of-eight suturing in upper and lower gastrointestinal anastomosis. Singapore Medical Journal. 2008 Sep; 49(9): 672.

Ayub MU, Sheikh RA, Gangat SH, Rehman AN, Memon IA. Single layer versus two layer intestinal anastomosis–a prospective study. Pakistan Journal of Surgery. 2009; 25(3): 141-3.

Ikram A, Hussain Shah SI, Naseem S, Absar SF, Ullah S, et al. Status of hospital infection control measures at seven major tertiary care hospitals of northern Punjab. Journal of College of Physicians and Surgeons Pakistan. 2010 Apr; 20(4): 266-70.

Ahmad S. Routine Use of Loopogram/contrast Radiology Prior to Post Typhoid Ileostomy Reversal. Pakistan Journal of Medical & Health Sciences. 2011 Sep; 5(3); 570-574.

Connolly PT, Teubner A, Lees NP, Anderson ID, Scott NA, Carlson GL. Outcome of reconstructive surgery for intestinal fistula in the open abdomen. Annals of Surgery. 2008 Mar; 247(3): 440-4. doi: 10.1097/SLA.0b013e3181612c99. DOI: https://doi.org/10.1097/SLA.0b013e3181612c99

Murtaza B, Khan NA, Sharif MA, Malik IB, Mahmood A. Modified midline abdominal wound closure technique in complicated/high risk laparotomies. Journal of College of Physicians and Surgeons Pakistan. 2010 Jan; 20(1): 37-41. doi:

Bruining DH, Zimmermann EM, Loftus Jr EV, Sandborn WJ, Sauer CG, Strong SA, Society of Abdominal Radiology Crohn’s Disease-Focused Panel. Consensus recommendations for evaluation, interpretation, and utilization of computed tomography and magnetic resonance enterography in patients with small bowel Crohn’s disease. Radiology. 2018 Mar; 286(3): 776-99. doi: 10.1148/radiol.2018171737. DOI: https://doi.org/10.1148/radiol.2018171737

Guglielmo FF, Anupindi SA, Fletcher JG, Al-Hawary MM, Dillman JR, Grand DJ et al. Small bowel Crohn disease at CT and MR enterography: imaging atlas and glossary of terms. Radiographics. 2020 Mar; 40(2): 354-75. doi: 10.1148/rg.2020190091 DOI: https://doi.org/10.1148/rg.2020190091

James A, Dillep C. LeboN the Use of Drains after Gastrointestinal Surgery. Recent advances in surgery. Irvin Taylor. Colin Johnson. 2009: 13-26.

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Published

2024-04-30
CITATION
DOI: 10.54393/pjhs.v5i04.1511
Published: 2024-04-30

How to Cite

Raza, A., Talpur, A. A., Khatti, S. N., Agha, A. H., Rizvi, M. B., & Ahmad, Z. (2024). Utility of Distal Loopogram Prior to Post Typhoid Ileostomy Reversal: Distal Loopogram for Typhoid Ileostomy Reversal. Pakistan Journal of Health Sciences, 5(04), 151–155. https://doi.org/10.54393/pjhs.v5i04.1511

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