Pattern of Presentation, Complications and Outcome of Typhoid Ileal Perforation

Hadees, Mazhar Iqbal, Mukhtar Ahmed, Sittara, Moazam Safiullah, Hunain Hassan

Abstract

Objective

To determine the pattern of presentation, complications and outcome in patients with typhoid ileal perforation.

Study design

Descriptive cross sectional study.

Place & Duration of study

Department of Surgery Ward II, Jinnah Postgraduate Medical Centre (JPMC) Karachi, from February 2023 to July 2024.

Methods

Patients who were diagnosed with typhoid ileal perforation were included. Clinical features, blood culture reports, operative findings, histopathology results, morbidity and mortality were noted. SPSS version 27 was used for data entry and analysis by application of descriptive statistics.

Results

Total of 82 patients were enrolled in the study. There were 52 (63.41%) males and 30 (36.59%) females. Mean age of the patients was 25+10 years. Thirty-four (41.46%) patients had fever of less than 7-days duration. Free gas under diaphragm was noted in 47 (57.31%) patients. Single ileal perforation was found in 64 (78.04%) cases. Complications included burst abdomen (n=14 - 17.07%) and wound infection (n=28 - 34.14%), In four ((4.87%) patients, re-exploration was done. Ilesotomy was made in thirty patients. Stoma related complications were  noted  in five patients. Seven (8.53%) patients who presented after 48 - hours, expired.

Conclusion

Younger age group males were most commonly affected by typhoid ileal perforation. Number of patients presented with history of fever of less than 7-days. Mortality was more in patients who required ventilator support. Common complications included wound infection and burst abdomen.

Key words

Typhoid perforation, Salmonella typhi, Peritonitis, Ileal perforation.