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Typhoid ileal perforation: surgical experience of 64 cases

J Kouame1, L Kouadio, H T Turquin

  • 1Service de chirurgie générale et digestive CHU de Treichville, BP V 3 Abidjan Côte d'Ivoire.

Acta Chirurgica Belgica
|October 8, 2004
PubMed
Abstract

Insights

Surgical treatment for typhoid ileal perforation in developing countries has high mortality. Early aggressive resuscitation, ileum resection, and abdominal washout may improve outcomes for patients with typhoid intestinal complications.

Area of Science:

  • Surgery
  • Infectious Diseases
  • Gastroenterology

Background:

  • Typhoid fever frequently causes intestinal complications in developing nations.
  • Typhoid ileal perforation presents a significant surgical challenge with high morbidity and mortality.

Purpose of the Study:

  • To report surgical experience with typhoid ileal perforation.
  • To identify factors influencing outcomes and suggest improvements.

Main Methods:

  • A retrospective analysis of 64 patients undergoing surgery for typhoid ileal perforation between May 1995 and July 1998.
  • Surgical techniques included excision-suture (n=31) and resection-ileostomy (n=33).
  • Standardized pre-, per-, and postoperative care was applied.

Main Results:

  • High postoperative complication rate (88.1%) and mortality (34%).
  • Major causes of death included digestive fistula (11 cases) and chronic peristomal ulceration (9 cases).
  • Mean hospital stay was 30 days.

Conclusions:

  • Mortality and morbidity remain unacceptably high for surgically treated typhoid ileal perforation.
  • Recommendations for improved outcomes include aggressive intravenous hydration, appropriate antibiotics, resection of the distal ileum in severe cases, and thorough abdominal washout.

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