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Typhoid ileal perforations: a retrospective study.

V Sitaram1, B V Moses, A S Fenn

  • 1Department of Surgery, Christian Medical College and Hospital, Tamil Nadu, India.

Annals of the Royal College of Surgeons of England
|November 1, 1990
PubMed
Summary
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This study on typhoid ileal perforation found that longer delays and multiple perforations worsened outcomes. Trimming the ulcer with closure significantly reduced mortality compared to simple closure.

Area of Science:

  • Surgery
  • Tropical Medicine
  • Gastroenterology

Background:

  • Typhoid ileal perforation is a serious complication of Salmonella Typhi infection.
  • Understanding prognostic factors is crucial for improving patient outcomes.

Purpose of the Study:

  • To identify characteristics and prognostic determinants in patients with typhoid ileal perforation.
  • To compare the outcomes of different surgical management strategies.

Main Methods:

  • Retrospective analysis of 124 patients treated for typhoid ileal perforation over 17 years (ending 1986).
  • Identification of adverse prognostic factors including fever/perforation interval, perforation/operation interval, and number of perforations.
  • Comparison of mortality rates between simple closure and ulcer trimming with closure surgical techniques.

Related Experiment Videos

Main Results:

  • Three adverse prognostic determinants identified: prolonged fever/perforation interval, prolonged perforation/operation interval, and multiple perforations.
  • Simple closure in 74 patients resulted in a 31.1% mortality rate.
  • Trimming of the ulcer with closure in 38 patients showed a significantly lower mortality rate of 7.9%.

Conclusions:

  • Surgical timing and the extent of intestinal involvement are critical in typhoid ileal perforation.
  • Ulcer trimming with closure appears to be a superior surgical technique, reducing mortality.
  • Further research into optimal surgical management for typhoid ileal perforation is warranted.