Childhood Typhoid Intestinal Perforation in Aba, Nigeria

Abstract

Typhoid intestinal perforation is still prevalent in many low and middle income countries. This may be due to lack of potable water, poor refuse disposal and health education. This study is to evaluate the outcome of management of typhoid intestinal perforation in children at the Abia State University Teaching Hospital Aba Nigeria. This is a prospective study of children who were managed for typhoid intestinal perforation at the Paediatric Surgery unit, department of Surgery of the Abia State University Teaching Hospital Aba Nigeria from November 2016 to September 2018. Proforma was opened for demography, clinical features, investigation, site of perforation, type of surgery, complications and outcome. Data collected were analysed using SPSS computer software version 17 for proportions and percentages. Results: Sixty patients were seen over the sixteen months study period. Forty males and twenty females with a male to female ratio {2:1}. Their ages ranged from 3 years to 15 years with a mean age of 8.9 years. Fever, abdominal pain, vomiting and abdominal distension were the commonest clinical features in over 50% of patients. Doubled layer closure and resection and anastomosis of ileal segment were done in equal number of patients [20 patients each]. Surgical site infection was the most common complications in 50 [83.3%] of patients. Five patients died giving a mortality rate of 8.3%. Typhoid intestinal perforation is still a persistent scourge in low income countries. Morbidity is still high despite low mortality in this series. Early presentation, good nutrition and public health education will improve outcome.