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Typhoid enteric perforations.

V K Kapoor, M C Mishra, R Ardhanari

    The Japanese Journal of Surgery
    |May 1, 1985
    PubMed
    Summary
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    Typhoid enteric perforation, common in young males, was diagnosed clinically with radiological support. Simple surgical closure and drainage led to an 11% mortality rate, lower than previously reported.

    Area of Science:

    • Gastroenterology
    • Surgical Gastroenterology
    • Infectious Diseases

    Background:

    • Typhoid enteric perforation is a severe complication of Salmonella Typhi infection.
    • Early diagnosis and effective management are crucial for improving patient outcomes.
    • Previous studies report high mortality rates associated with typhoid perforation.

    Purpose of the Study:

    • To present the clinical features, diagnostic methods, and surgical management of typhoid enteric perforations.
    • To evaluate the outcomes and mortality associated with a specific surgical approach.
    • To compare the findings with existing literature on typhoid perforation management.

    Main Methods:

    • Retrospective analysis of 45 cases of typhoid enteric perforation.
    • Diagnosis based on clinical presentation, radiological evidence (pneumoperitoneum), and intraoperative findings (terminal ileum perforations).

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  • Surgical management involved simple closure of perforations and peritoneal drainage.

    • Main Results:

    • The condition predominantly affected young males, with perforations often occurring in the second week of fever.
    • Clinical diagnosis supplemented by pneumoperitoneum was key; Widal test and blood cultures showed limited utility.
    • Postoperative complications included burst abdomen (9%) and fecal fistula (20%).

    Conclusions:

    • Simple closure and drainage offer a viable surgical strategy for typhoid enteric perforations.
    • The observed 11% mortality rate is significantly lower than previously reported figures.
    • This approach may contribute to reduced morbidity and mortality in managing this surgical emergency.