Typhoid intestinal perforation in North Central Nigeria

Ugwu, B T; Yiltok, SJ; Kidmas, AT; Opaluwa, AS

doi:10.4314/wajm.v24i1.28152

Cited by 41 publications

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“…The most common symptoms are pain abdomen and fever [11]. In these series 38 patients presented with pain abdomen.…”

Section: Resultsmentioning

confidence: 99%

Journal of Clinical and Diagnostic Research. 2013 Sept, Vol-7(9): 1946-1948 1946 1946 DOI: 10.7860/JCDR/2013/6632.3366 Original Article

Pujar¹

2013

JCDR

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Background: Typhoid fever is an important public health problem in developing countries. Intestinal perforation is one of the leading fatal complications of typhoid fever. Typhoid perforation occurs more commonly in terminal ileum. Morbidity and Mortality associated with typhoid perforation are high (9-22%). However this study aims to know whether there are any changes of the same. Aim:To analyse the clinical presentation, management, complications, morbidity and mortality associated with typhoid intestinal perforation and assess changing trends in mortality in typhoid intestinal perforation. Material & Methods:This is a retrospective observational study. Cases regarding the study have been analyzed by reviewing the patient records. It includes 40 patients who were diagnosed with typhoid intestinal perforation, admitted and treated in the Department of General Surgery from February 2011 to January 2012.Results: A total of 40 patients were considered for the study and their mean age was 35.75 years. 80% of patients were male. Pain abdomen was their main symptom which lasted for an average of 2.95 days. Leukocytosis (11,000 cells/cumm) was present in 57.5% patients. Single perforation was present in 31(77.5%) patients and primary closure was done in 30 of them. Culture sensitivity showed E coli as the main organism. Complications were seen in 42.5% of patients in post-operative period. Conclusion:Early recognition, timely surgical intervention with appropriate surgery and antibiotics, and effective peri-operative care reduces the mortality in typhoid intestinal perforation.

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“…The most common symptoms are pain abdomen and fever [11]. In these series 38 patients presented with pain abdomen.…”

Section: Resultsmentioning

confidence: 99%

Journal of Clinical and Diagnostic Research. 2013 Sept, Vol-7(9): 1946-1948 1946 1946 DOI: 10.7860/JCDR/2013/6632.3366 Original Article

Pujar¹

2013

JCDR

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“…Other studies have similarly reported male 7,8 preponderance and a younger age group. The youngest patient in the present study was 6 11 years. Ugwu et al reported 101 cases of perforated typhoid over a 10 year period in Jos, with children under 16 years of age accounting for about 49%.…”

Section: Discussionmentioning

confidence: 97%

“…Only the patient that had 3 perforations had a resection and end to end anastomosis. Other studies have similarly emphasized the effectiveness of simple closure of perforations especially [5][6][7] when dealing with single perforations. But for multiple perforation, most studies are in 7 favour of resection and anastomosis.…”

Section: Discussionmentioning

confidence: 99%

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Pattern and Outcome of Typhoid Perforation in Benin City

Osime¹,

Osifo²

2009

Journal of Medicine and Biomedical Research

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Over a 26-year period, there were only twenty four cases of perforated typhoid that were operated at the University of Benin Teaching Hospital. Four cases had incomplete data and were excluded from the study and only twenty cases were therefore included in the study. Of the twenty patients, there were 12 males and 8 females and the age range was between 11 and 45 years, with a mean of 25.65 years. The main complaints were fever, abdominal pain, vomiting, diarrhea or constipation. Most of the patients presented late to the hospital. Most of the patients had single perforations. Simple closure was the method of treatment in most of the patients. Wound infection was the major post operation complication. The average hospital stay was 16.3 days. We conclude that compared with other tertiary health institutions in Nigeria, the incidence of typhoid perforation is low at the University of Benin Teaching Hospital, Benin City, Nigeria and simple closure of perforations is efficient in managing typhoid perforations.

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“…4 The management of typhoid intestinal perforation poses a diagnostic and therapeutic challenge to general surgeons practicing in resource-limited countries. 5,6 Surgery is considered to be the treatment of choice in these patients, who most often present late. 7 However, there is no consensus regarding the best procedure to be performed in such a case.…”

Section: Introductionmentioning

confidence: 99%

Surgical management and prognosis of perforation secondary to typhoid fever

Jain¹,

Meena²,

Ram³

2016

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Introduction: Enteric perforation is a serious complication of typhoid fever and the condition has a high morbidity and mortality in many developing countries including India. No consensus exists concerning the best procedure to be performed in these cases. Aim: The purpose of this study was to analyse our clinical experience in surgical management of enteric perforation and to determine the prognostic factors associated with morbidity and mortality. Methods: It was a prospective study of patients who underwent surgery for typhoid intestinal perforation at SMS Medical College and Hospital, Jaipur, India, between April 2012 and October 2013. Laparotomy was performed by a midline incision. Management of perforation was based on the intraoperative findings and the procedure to be performed was decided by the operating surgeon. Results: 88 patients were studied with a male to female ratio of 6.3:1. The mean age was 36.4 years. The peak incidence was between 21 to 30 years. All the patients presented with abdominal pain and distension. More than 90% patients showed free gas under diaphragm. 71% patients had a single perforation and 97% patients had perforations confined to ileum. Debridement with double layered closure was performed in about 58% patients, ileostomy in 25% and resection anastomosis in 18% of patients. Overall complication rate was 44.3% with surgical site infection being the most common morbidity. The mortality rate was 17.1% which was significantly affected by perforation-admission interval of more than 48 hours, number of perforations and occurrence of postoperative complications. Conclusion: Typhoid fever leading to development of intestinal perforation continues to be a significant health problem with a high morbidity and mortality especially in rural India. The management of the disease requires an early and appropriate surgical intervention.

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Typhoid intestinal perforation in North Central Nigeria

Cited by 41 publications

References 0 publications

Journal of Clinical and Diagnostic Research. 2013 Sept, Vol-7(9): 1946-1948 1946 1946 DOI: 10.7860/JCDR/2013/6632.3366 Original Article

Journal of Clinical and Diagnostic Research. 2013 Sept, Vol-7(9): 1946-1948 1946 1946 DOI: 10.7860/JCDR/2013/6632.3366 Original Article

Pattern and Outcome of Typhoid Perforation in Benin City

Surgical management and prognosis of perforation secondary to typhoid fever

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