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Typhoid Fever Presenting with Ileal Perforation and Gastric Perforation
M M Muhammed1, K J Bwala1, J O Okoruwa1
1Department of Surgery, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria. Email: Dr.muhammedmurtala@gmail.com +2348061666943.
Insights
Typhoid fever can cause life-threatening intestinal perforations. This case highlights a rare gastric perforation in a teen, emphasizing the need for prompt diagnosis and treatment of typhoid complications.
Area of Science:
- Medicine
- Infectious Diseases
- Pediatrics
Background:
- Typhoid fever, caused by Salmonella typhi and Salmonella paratyphi, is prevalent in developing nations, disproportionately affecting low socio-economic populations.
- Intestinal perforation is a severe complication of typhoid fever, significantly increasing mortality rates.
Observation:
- A 15-year-old female presented with sepsis, respiratory distress, and peritonitis, indicative of a surgical emergency.
- Clinical assessment suggested generalized peritonitis secondary to typhoid intestinal perforation.
Findings:
- Exploratory laparotomy revealed both ileal and gastric perforations.
- The patient underwent surgical repair for both intestinal and gastric perforations.
Implications:
- Concurrent NSAID use and overwhelming sepsis may have contributed to the unusual gastric perforation in this typhoid case.
- This case underscores the importance of early diagnosis and management of typhoid fever complications, including rare presentations like gastric perforation.
- Prevention through safe water, sanitation, and hygiene remains crucial for controlling typhoid fever and its severe outcomes.
Abstract:
Typhoid fever is caused by Salmonella typhi and Salmonella paratyphi. It is a disease of developing countries and is seen among people of low socio-economic status. Patients can develop complications like typhoid intestinal perforation which is associated with higher mortality. A 15-year-old female presented to the emergency pediatric unit with fever, abdominal pain and abdominal distension. She was septic, in respiratory distress, and had marked generalized abdominal tenderness with guarding. An assessment of generalized peritonitis secondary to typhoid intestinal perforation was made. She had exploratory laparotomy with intra-operative findings of ileal perforation and gastric perforation. She had repair of the intestinal and gastric perforations. Our patient presented late with concurrent use of NSAIDs and overwhelming sepsis which likely contributed to the gastric perforation as this is not a usual finding in patients with typhoid intestinal perforation. Gastric perforation is an unusual finding in patients with typhoid intestinal perforation. Typhoid fever and its complications can be easily prevented by the provision of safe water, proper facilities for sanitation, and practicing good hygiene.
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