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[Intestinal perforation in juvenile abdominal typhoid]
Insights
Intestinal perforation occurred in eight of 19 children with typhus abdominalis, always in the terminal ileum. X-ray findings, including small intestine meteorism, are similar to adults.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Radiology
Background:
- Typhus abdominalis, a severe infectious disease, can lead to serious complications in children.
- Intestinal perforation is a critical complication requiring prompt diagnosis and management.
Observation:
- Radiographic examination of children aged 4-12 with typhus abdominalis revealed specific signs.
- Key observations included intestinal perforation, meteorism of the small intestine, and in some cases, ileus.
Findings:
- Eight out of 19 pediatric patients (4-12 years) with typhus abdominalis presented with intestinal perforation.
- Perforation consistently localized to the terminal ileum, typically occurring between the second and fourth week of illness.
- Radiographic findings in children mirrored those seen in adults, with visualized free air and small bowel distension.
Implications:
- Early recognition of these radiographic signs is crucial for timely surgical intervention in pediatric typhus abdominalis.
- The consistent localization of perforation to the terminal ileum aids in surgical planning and diagnosis.
- Understanding these radiographic patterns improves diagnostic accuracy and patient outcomes in pediatric typhus abdominalis.
Abstract:
Eight of 19 children with typhus abdominalis who were between 4 and 12 years of age, showed perforation of the intestine. The terminal ileum was always the site of the perforation. Besides the clearly visualized air, meteorism of the small intestine was always seen. In individual cases, segments of the small intestine were seen in close proximity to each other, or an ileus developed. The x-ray film in typhus abdominalis in childhood shows the same signs as an adult x-ray. A characteristic feature of the perforation is its localization in the terminal ileum and the time at which it occurs, namely, between the end of the 2nd and the end of the 4th week of the diseased condition.