fecaloid

As depicted simple debridement and closure of the perforation is most commonly employed procedure in our setup but in severely contaminated cases with friable terminal ileum (those with delayed presentation, multiple perforations, faecaloid peritonitis), obviously something more than mere closure of perforations needs to be done to reduce the incidence of most deadly complication like faecal fistula.

However, in the patients where the terminal ileum is grossly inflamed with multiple perforations, perforation-operation delay >48 hours, faecaloid peritonitis; something more than mere closure of perforation needs to be done and end-to-side ileotransverse anastomosis is a better procedure.