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Year : 2008  |  Volume : 11  |  Issue : 1  |  Page : 58-62

Typhoid ileal perforation : analysis of morbidity and mortality in 89 children

Department of Pediatric Surgery, University of Nigeria Teaching Hospital, Enugu

Correspondence Address:
S O Ekenze
Department of Pediatric Surgery, University of Nigeria Teaching Hospital, Enugu

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Source of Support: None, Conflict of Interest: None

PMID: 18689141

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BACKGROUND: Typhoid ileal perforation is still prevalent in many developing countries. Despite the advances in the management, the outcome in children is still very poor. OBJECTIVE: To determine the morbidity and mortality of childhood typhoid ileal perforation in a tertiary referral centre in southeast Nigeria. METHODS: Retrospective evaluation of 89 children operated for typhoid ileal perforation over a 10-year period (January 1, 1995 through December 31, 2004) at the University of Nigeria Teaching Hospital, Enugu. RESULTS: There were 54 (60.7%) boys and 35 (39.3%) girls aged 1 15 years (mean 9.1 years). Thirty-nine (43.8%) were > 10 years. Fever and generalized abdominal pain were the predominant symptoms for 5 21 days (mean 13.4 days) and 2 13 days (mean 8.8 days) respectively before presentation; Seventeen (89.5%) of those < 5 years had vomiting. Pneumoperitoneum was demonstrated radiologically in 59 (66.3%) children. Surgical treatment involved simple closure in 46 (51.7%) children and segmental intestinal resection in 43 (48.3%). Surgical site infection 41 (46.1%), chest infection 21 (23.6%) and reperforation 19 (21.3%) were the commonest postoperative complications. The overall mortality was 17 (19.1%) from overwhelming infection. Age < 5 years and prolongation of perforation-operation interval worsened morbidity and mortality. CONCLUSION: Typhoid ileal perforation in childhood is associated with high morbidity and mortality. Outcome can be improved by early presentation and intervention.

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