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Colonic perforations in enteric fever

Naseem Uddin1, Muhammad Arif Mateen Khan, Zareen Tasneem

  • 1Department of Paediatric Surgery, The Aga Khan University Hospital, Karachi, Pakistan.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|October 1, 2004
PubMed

Insights

Typhoid fever can cause serious complications like multiple colonic perforations in children. Prompt surgical intervention is crucial for managing this rare but life-threatening condition.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Surgical Case Reports

Background:

  • Typhoid fever, caused by Salmonella Typhi, is a significant global health concern, particularly in endemic areas.
  • While gastrointestinal complications are known, multiple colonic perforations are a rare and severe manifestation, especially in pediatric patients.
  • Early recognition and management are critical for improving patient outcomes.

Observation:

  • A 5-year-old boy presented with a nine-day history of high-grade fever and severe abdominal pain.
  • Clinical examination revealed signs of an acute abdomen, indicating a serious intra-abdominal pathology.
  • Initial workup and resuscitation were followed by emergency laparotomy.

Findings:

  • Laparotomy revealed multiple perforations of the colon.
  • The presence of fecal peritonitis was confirmed, signifying widespread intra-abdominal contamination.
  • The case highlights the potential for extensive colonic involvement in severe typhoid fever.

Implications:

  • This case underscores the importance of considering typhoid fever as a cause of acute abdomen and intestinal perforation in children, even in regions where it is less common.
  • It emphasizes the necessity of a thorough intra-abdominal examination during surgery, including inspection of the entire colon, to identify all sites of perforation.
  • Effective management requires prompt surgical intervention and appropriate antimicrobial therapy to address both the perforation and the underlying infection.

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