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Typhoid intestinal perforation under 5 years of age

Sebastian O Ekenze1, Anthony N Ikefuna

  • 1Department of Paediatric Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria. soekenze@yahoo.com

Annals of Tropical Paediatrics
|March 6, 2008
PubMed

Insights

Typhoid intestinal perforation presents differently in children under five, with atypical symptoms and a higher mortality rate. Early recognition of these unique features is crucial for improving outcomes in young children.

Area of Science:

  • Pediatric Surgery
  • Infectious Diseases
  • Gastroenterology

Background:

  • Typhoid intestinal perforation is a significant cause of illness and death in developing nations.
  • Understanding the unique characteristics of perforation in children under five is vital for better patient outcomes.

Purpose of the Study:

  • To define the specific patterns and outcomes of typhoid intestinal perforation in children under five years old in south-east Nigeria.

Main Methods:

  • A comparative analysis was conducted on 83 children diagnosed with typhoid intestinal perforation.
  • Data was collected from January 2001 to December 2006 at the University of Nigeria Teaching Hospital, Enugu.

Main Results:

  • Children under five (26.5%) showed different symptoms (fever, vomiting, abdominal tenderness) compared to older children (fever, abdominal pain, distension).
  • Younger children had fewer signs of peritonitis (54.5% vs 90.2%) and more perforations (average 2.1 vs 1.3).
  • Mortality was significantly higher in children under five (40.9% vs 19.7%).

Conclusions:

  • Typhoid intestinal perforation in children under five presents atypically and is associated with a high mortality rate.
  • A heightened clinical suspicion is necessary for earlier diagnosis and potentially improved outcomes.
Abstract

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