Perforated typhoid enteritis. The problem of intestinal fistula

Typhoid enteritis with perforation is still a major problem in many hospital centres in the tropics and post-operative intestinal fistula accounts for much of the morbidity and mortality among those who survive the septicaemic phase of the disease. In poorly equipped hospitals with limited resources, early aggressive re-exploration to close the intestinal fistula when the patient is still strong is advocated in preference to conservative treatment which is prolonged, of uncertain outcome and liable to be abandoned especially where the patient is poor and unable to provide the material for fluid replacement and nutritional support over a long period of time.