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Related Experiment Videos

Comparison of three operations for typhoid perforation

E A Ameh1, P M Dogo, M M Attah

  • 1Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.

The British Journal of Surgery
|April 1, 1997
PubMed
Summary

Segmental resection is the optimal surgical approach for typhoid perforation, significantly reducing reperforation and mortality risks compared to simple closure or wedge excision. This method is recommended for similar healthcare settings.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Infectious Diseases

Background:

  • Typhoid fever is a significant public health issue in developing nations.
  • Gut perforation is a life-threatening complication of typhoid fever.
  • Surgical management of typhoid perforation, particularly the extent of surgery, remains debated.

Purpose of the Study:

  • To compare the outcomes of three surgical procedures for typhoid perforation.
  • To evaluate reperforation risk, mortality rates, and hospital stay duration.
  • To determine the most effective surgical strategy for typhoid perforation.

Main Methods:

  • A prospective study involving 64 patients with suspected typhoid perforation.
  • Patients were treated with either simple closure, wedge excision and anastomosis, or segmental resection and anastomosis.

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  • Standardized management protocols were applied across all groups.

    • Main Results:

    • Segmental resection had the lowest risk of reperforation (0/25) and mortality (9/25).
    • Simple closure showed intermediate results with 0/18 reperforation and 9/18 mortality.
    • Wedge excision had the highest reperforation (2/21) and mortality (13/21) rates.

    Conclusions:

    • Segmental resection and anastomosis is the preferred surgical treatment for typhoid perforation.
    • This approach offers superior outcomes in terms of reduced morbidity and mortality.
    • Recommendations are made for surgeons in similar resource-limited environments.