Typhoid ileal perforation in Nigerian children: an analysis of 106 operative cases

Typhoid ileal perforation (TP) is a major problem in developing countries and carries a high mortality. The purpose of this retrospective study from Nigeria was to review the outcome in children less than 15 years of age who underwent surgery for TP from 1984 to 1999. Demographic data, clinical feat...

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Bibliographic Details
Published in:Pediatric surgery international 2001-11, Vol.17 (8), p.628-630
Main Authors: RAHMAN, G. A, ABUBAKAR, A. M, JOHNSON, A-W. B. R, ADENIRAN, J. O
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Child
Child, Preschool
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Ileal Diseases - microbiology
Ileal Diseases - surgery
Intestinal Perforation - microbiology
Intestinal Perforation - surgery
Length of Stay
Male
Medical sciences
Nigeria
Other diseases. Semiology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
Tropical medicine
Typhoid Fever - complications
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Summary:Typhoid ileal perforation (TP) is a major problem in developing countries and carries a high mortality. The purpose of this retrospective study from Nigeria was to review the outcome in children less than 15 years of age who underwent surgery for TP from 1984 to 1999. Demographic data, clinical features, results of investigations, findings at surgery, postoperative course, and complications were recorded. There were 55 boys and 51 girls. The median age at presentation was 10 years (range 3-14). The surgically confirmed perforation rate was 11.0%. The clinical features in children older than 5 years were similar to already documented patterns in the literature. In children less than 5 years old the predominant symptoms were fever and vomiting only. Therefore, in the very young a high index of suspicion is required to avoid delay in diagnosis. Ninety eight patients (92.5%) had simple double-layer closure of the perforation. The mean hospital stay among survivors was 23.6 +/- 18.8 days. The commonest postoperative complications were wound infection and enterocutaneous fistula. The overall mortality was 23.8%, increasing to 50% in children aged less than 5 years, although the difference was not statistically significant (P > 0.05). To improve survival in TP, attention should be focused on perioperative resuscitation and early intervention. The provision of potable water, adequate sanitation, and active immunisation are means to eradicate the disease.
ISSN:0179-0358
1437-9813
DOI:10.1007/s003830100008