Prognostic factors in typhoid ileal perforation: a prospective study of 53 cases

J Natl Med Assoc. 2007 Sep;99(9):1042-5.

Abstract

Background: Typhoid ileal perforation remains a serious complication of typhoid enteritis with high morbidity and mortality in many tropical countries.

Aims and objectives: To determine the prognostic factors in typhoid perforation in Kano, Nigeria.

Methodology: Fifty-three consecutive patients with typhoid perforation managed surgically were prospectively studied at the general surgical unit of Aminu Kano Teaching Hospital Kano, from March 2004 to February 2006.

Results: There were 26 (49.1%) males and 27 (50.9%) females, with age range of 2-55 years and a mean +/- SD of 12.2 +/- 10.2 years. The morbidity was 49.1% and the most common postoperative complications included wound infection, wound dehiscence, burst abdomen, residual intra-abdominal abscesses and enterocutaneous fistula. Mortality was 15.1% and was significantly affected by multiple perforations, severe peritoneal contamination and burst abdomen (p value <0.05, odds ratio >1). The mean duration of hospital stay for survivors was 16.1 days with a range of 8-57 days.

Conclusion: This study has attempted to determine the factors that statistically influence mortality in typhoid perforation in our environment.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Enteritis / etiology*
  • Enteritis / mortality
  • Enteritis / surgery
  • Female
  • Humans
  • Ileal Diseases / etiology*
  • Ileal Diseases / microbiology
  • Intestinal Perforation / etiology*
  • Intestinal Perforation / microbiology
  • Male
  • Middle Aged
  • Nigeria / epidemiology
  • Postoperative Complications
  • Prognosis
  • Prospective Studies
  • Survival
  • Treatment Outcome
  • Typhoid Fever / complications*
  • Typhoid Fever / mortality
  • Typhoid Fever / surgery