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The surgical management of typhoid perforation in children
The British Journal of Surgery
|December 1, 1984
Insights
Typhoid perforation in children has high mortality. This study shows a surgical approach with ulcer excision, closure, and lavage achieved a 9.0% operative mortality in 26 pediatric cases.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Gastrointestinal Surgery
Background:
- Typhoid perforation presents a significant challenge in pediatric surgical care.
- High mortality rates (19-59%) are associated with typhoid perforation, with ongoing debate regarding optimal management strategies.
Purpose of the Study:
- To report the outcomes of a specific surgical approach for typhoid perforation in children.
- To evaluate the efficacy and safety of timed surgery with ulcer excision, simple closure, and peritoneal lavage.
Main Methods:
- Retrospective analysis of 26 children with histologically confirmed typhoid perforation.
- Surgical intervention involved timed procedures, excision of the perforated ulcer, two-layer closure of the defect, and extensive peritoneal lavage.
Main Results:
- The study included 26 pediatric patients diagnosed with typhoid perforation.
- The implemented surgical strategy resulted in an operative mortality rate of 9.0%.
Conclusions:
- Timed surgical intervention, including ulcer excision, simple closure, and peritoneal lavage, is an effective management strategy for pediatric typhoid perforation.
- This approach can significantly reduce the operative mortality associated with this severe complication.
Abstract:
Typhoid perforation still has a high mortality rate (19-59 per cent) and controversy regarding the management of patients with this complication still abounds. We report our experience of 26 children with histologically proven typhoid perforation with an operative mortality of 9.0 per cent. Timed surgery with ulcer excision, simple two-layer closure of the defect and copious peritoneal lavage were used.