East Surgical Ward Enteric Perforation Score: A Novel Scoring System for Swift Decision in Enteric Perforation

Background: For enteric perforation the ESWEP Score is a metric designed to determine whether to perform ileostomy or primary closure. The Objective of this study was to compare the outcomes of primary repair and ileostomy in regard to ESWEP score and effectiveness of ESWEP score in both surgical methods. Methods: This comparative cross-sectional study was carried out at surgical department of LUMHS, Jamshoro for 06 months from January 2024 to June 2024. 52 individuals fulfilling the criteria were selected and grouped as PR (Primary Repair) and PR+1 (ileostomy). Preoperative ESWEP score was calculated and based on a cut off of 13 the patients with a score of 13 underwent PR and those with a score 13 underwent PR with ileostomy. Per-operative findings observed and outcomes were analysed. Results: Mean ages of the patients in the PR group were 36 8.14 years and in the PR+I group were 37 9.23 years. The mean pre-operative ESWEP score in the PR group was 5 0.78 and in the PR+I group was 16 1.72. The mean per-operative ESWEP score in the PR group was 6 0.77 and in the PR+I group it was 14 4.17. The mean total ESWEP score in PR group was 11 1.23 and in the PR+I group it was 30 4.06. Surgery related and systemic complications were significantly less in the PR group. Conclusion: This study concluded that ESWEP score in patients with typhoid perforation was a useful guide for the surgeons for making decisions regarding PR alone or primary repair with ileostomy and PR alone.