Abstract
Background
Typhoid fever (TF) is a severe febrile illness caused by Salmonella typhi. One of the most lethal complications of TF is ileal perforation (TIP). Although the mortality of associated with TIP has decreased slightly over the past decade, it is still high.
Methods and Results
The records of the 82 surgically treated patients with TIP were evaluated retrospectively. There were 64 men with the mean age of 36.3 years (range: 7–68 years). In surgical treatment, debridement with primary closure was performed in 32 patients (39.0%), and wedge resection with primary closure was performed in 9 (11. 0%), resection with primary anastomosis in 9 (11.0%), and resection with ileostomy in 32 (39.0%). The most common postoperative complication was wound infection, which occurred in 24 patients (29.3%). The overall morbidity was highest in the ileostomy group. The overall mortality was 11.0% (9 patients). Age, gender, number, and localization of the perforations (p > 0.05) were not found to affect mortality, but prolonged preoperative period (p < 0.001), extended peritoneal contamination (p < 0.01), and ileostomy procedure (p < 0.001) were found to influence the increase in mortality.
Conclusions
Early and appropriate surgical intervention with effective preoperative and postoperative care may improve survival in TIP.
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References
Hosoglu S, Aldemir M, Akalin S, et al. (2004) Risk factors for enteric perforation in patients with typhoid fever. Am J Epidemiol 160:46–50
Rahman GA, Abubakar AM, Johnson A-WBR (2001) Typhoid ileal perforation in Nigerian children: an analysis of 106 operative cases. Pediatr Surg Int 17:628–630
Parry CM, Hien TT, Dougan G (2002) Typhoid fever. N Engl J Med 347:1770–1782
Saxe JM, Cropsey R (2005) Is operative management effective in treatment of perforated typhoid? Am J Surg 189:342–344
Adesunkanmi ARK, Ajao OG (2002) The prognostic factors in typhoid ileal perforation: a prospective study of 50 patients. JR Coll Surg Edinb 42:395–399
Shukla VK, Sahoo SP, Chauhan VS (2004) Enteric perforation-single-layer closure. Dig Dis Sci 49:161–164
Onen A, Dokucu AI, Cigdem MK (2002) Factors effecting morbidity in typhoid intestinal perforation in children. Pediatr Surg Int18:696–700
Abantanga FA, Wiafe-Addai BB (1998) Postoperative complications after surgery for typhoid perforation in children in Ghana. Pediatr Surg Int 14:55–58
Oren D, Atamanalp SS (1991) Intestinal perforations due to Typhus. Turk J Dis Colon Rectum 3:124–127
Beniwal U, Jindal D, Sharma J (2003) Comparative study of operative procedures in typhoid perforation. Indian J Surg 65:172–177
Fernandez-Mena C, Mazwai EL, Pandey SR, et al. (2003) Established peritonitis due to typhoid perforation. Electron J Biomed 1:139–143
Meier DE, Tarpley JL (1998) Typhoid intestinal perforations in Nigerian children. World J Surg 22:319–323
Akgun Y, Bac B, Boylu S, et al. (1995) Typhoid enteric perforation. Br J Surg 82:1512–1515
Meier DE, Imediegwu OO, Tarpley JL, et al. (1989) Perforated typhoid enteritis: operative experience with 108 cases. Am J Surg 157:423–427
Na’aya HU, Eni UE, Chama CM (2004) Typhoid perforation in Maiduguri, Nigeria. Ann Afr Med 3:69–72
Ameh EA (1999) Typhoid ileal perforation in children: a scourge in developing countries. Ann Trop Pediatr 19:267–272
Ameh EA, Dogo PM, Attah MM, et al. (1997) Comparison of three operations in typhoid perforation. Br J Surg 84:558
Eustach JM, Kreis DJ (1983) Typhoid perforation of the intestine. Arch Surg 118:1269–1271
Ramachandran CS, Agarwal S, Goel Dip D (2004) Laparoscopic surgical management of perforative peritonitis in enteric fever. Surg Laparosc Endosc Percutan Tech 14:122–124
Sinha R, Sharma N, Joshi M (2005) Laparoscopic repair of small bowel perforation. JSLS 9:399–402
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The summary of this paper was accepted as a poster presentation at the 40th Congress of the European Society for Surgical Research, May 25–28, 2005, Konya, Turkey.
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Atamanalp, S.S., Aydinli, B., Ozturk, G. et al. Typhoid Intestinal Perforations: Twenty-six Year Experience. World J Surg 31, 1883–1888 (2007). https://doi.org/10.1007/s00268-007-9141-0
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DOI: https://doi.org/10.1007/s00268-007-9141-0