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Typhoid Perforation | Laparoscopic Typhoid Perforation Repair – Dr Tayyab Riaz Ch

40 Years Female presented to me with pain abdomen of two days history. She had fever from last 20 days. On examination: abdomen was tense and tender.

USG: Moderate ascities with particulate matter Xray abdomen+chest erect showed air under diaphragm.

Patient was hemodynamically stable with HB 11.5g/dl On high index of suspicion of typhoid perforation in terminal ileum Laparoscopy and proceed was planned ERAS protocol was followed and patient was discharged on 3rd post-op day when she was eating and passing stool & flatus.

ERAS Protocol

  • No NG tube – Early mobilization (in the evening of operation)
  • Foley removed in evening
  • Oral Sips started next day (1st post-op day)
  • Bowel sounds came back on 2nd post op day
  • Drain removed on day 4 when output was less than 50ml
  • IV antibiotic coverage (Inj Ceftriaxone 1g BD) given for 10 days.

Dr. Tayyab Riaz Ch (MBBS, FCPS) is a Consultant General and Advanced Laparoscopic and Minimal Invasive Surgeon currently working in a tertiary Care Teaching hospital in Faisalabad region of the Punjab, Pakistan.

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