Postoperative complications after surgery for typhoid ileal perforation in adults in Kumasi

The surgical complications of typhoid ileitis such as ileal perforations (TIP) continue to cause many deaths especially in countries with poor sanitation and limited health care facilities.

To assess and highlight the complications associated with typhoid ileal perforation

A prospective study of the postoperative complications after closure of TIP was conducted between Jan. 2002 and Dec. 2005 at the Komfo Anokye Teaching Hospital (KATIH.)

A total of 248 patients aged between 16 and 54 years with a mean age of 24.9 (8.3) and a median of 23.5 years were operated upon for TIP. There were 180 males (72.6%) and 68 females (27.4%) with a male to female ratio of 4: 1. The diagnosis of TIP was based on clinical, radiological and operative findings. The over all complication rate was 49.3%. The most common postoperative complication was wound infection (52.4 %). The most serious were persistent peritonitis (34.7%) and enterocutaneous fistula (10.0%) with a mortality of 33.3 % and 22.2 % respectively. The overall mortality was 10.9%. These complications significantly increased the duration of hospital stay of survivors by several days (p<0.01)

Very serious complications occur after surgery for TIP in adults. These complications may contribute to the high mortality from this disease.