Typhoid enteric perforation in north western Nigeria

Niger J Med. 2004 Oct-Dec;13(4):345-9.

Abstract

Background: Typhoid perforation is the most important surgical complication of typhoid enteritis and is associated with high morbidity and mortality.

Aims and objectives: To determine the pattern and outcome of management of typhoid perforation in Aminu Kano University Teaching Hospital, Kano.

Method: A retrospective Analysis of patients treated for typhoid perforation over a 6-year period.

Results: There were 47 patients: 35 males and 12 females, ratio 2.9 to 1. The patients were aged 4 years to 58 years (mean 18.9 years). Typhoid perforation occurred all the year round with a peak prevalence in September; Six (12.8%) patients perforated in the first week, 29 (61.7%) second week, and 12 (25.5%) third week, of illness. Single perforation was found in 91.5% of cases, and two to three perforations in 8.5%. Surgical treatment was by simple closure in 72.3%, wedge resection in 8.5%, ileal resection in 17.1% and right hemi-colectomy in 2.1%. Of the 41 survivors (87.2%), wound infection was the most common postoperative complication in 44.7% of cases. The mortality rate was 12.8% mostly due to overwhelming sepsis.

Conclusion: Typhoid perforation requiring surgical intervention is still endemic in our subregion, and emphasis should be on preventive measures such as safe drinking water and appropriate sewage disposal, and typhoid vaccination.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Female
  • Humans
  • Ileal Diseases / epidemiology
  • Ileal Diseases / etiology*
  • Ileal Diseases / surgery
  • Intestinal Perforation / epidemiology
  • Intestinal Perforation / etiology*
  • Intestinal Perforation / surgery
  • Male
  • Nigeria / epidemiology
  • Postoperative Complications / epidemiology
  • Typhoid Fever / complications*