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Non-traumatic ileal perforation: a retrospective study
Gurjit Singh1, Bharat Bhushan Dogra1, Neha Jindal1
1Department of General Surgery, Padmashree Dr. D. Y. Patil Hospital and Research Centre, Pune, Maharashtra, India.
Journal of Family Medicine and Primary Care
|August 28, 2014
Summary
Typhoid fever is the most common cause of non-traumatic ileal perforation in the region. Immunization against typhoid for individuals over 18 years old is recommended to prevent this serious condition.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Infectious Diseases
Background:
- Non-traumatic ileal perforation is a significant surgical emergency.
- Typhoid fever is a common cause of such perforations in endemic regions.
- Understanding clinical features and outcomes is crucial for effective management.
Purpose of the Study:
- To analyze clinical presentations, surgical findings, and postoperative complications in patients with non-traumatic ileal perforation.
- To evaluate the impact and role of typhoid vaccination in preventing ileal perforations.
Main Methods:
- A retrospective study was conducted between 2009 and 2010.
- Seven patients presenting with acute abdomen due to ileal perforation were included.
- Diagnosis involved clinical assessment, laboratory tests, radiology, and intraoperative findings. Management included exploratory laparotomy, simple closure, or resection with anastomosis.
Main Results:
- Clinical signs included tenderness, distension, and rigidity. Radiological findings often showed gas under the diaphragm.
- Typhoid (Salmonella typhi) was confirmed in four patients via positive Widal tests and blood cultures.
- Most perforations were single, located on the antimesenteric border of the ileum. Postoperative complications like wound infection and intra-abdominal abscess occurred in one patient each.
Conclusions:
- Management strategies for typhoid and non-specific ileal perforations are similar.
- Typhoid fever is the predominant cause of ileal perforation in the studied population.
- Routine typhoid immunization for adults over 18 is strongly recommended to reduce perforation incidence.
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