Abstract
Background: The management of typhoid ilial perforation in this low socioeconomic environment is really challenging because the population is predominantly peasant farmers lacking social amenities and quality water supply. Patients and Methods: The study retrospectively reviewed all patients diagnosed with typhoid perforation and managed in Damaturu and Potiskum district Hospitals North-Eastern Nigeria between January 2012 and December 2016. Results: A total of 279 patients were seen, 268 analyzed and 11 were excluded due to incomplete records. Age ranged from 3 to 50 years with male to female ration of 1.1:1 and a mean of 14.75 years. The peak age group was 11-20 years accounting for 39.93%. The clinical features were abdominal pain in 99.25% and abdominal tenderness in all patients. Procedures done were simple closure of perforation in 87.31% patients, resection and anastomosis in 70.84%. Post-operative complications were surgical site infection in 21.64%, and renal failure in 1.12%. The mortality was 14.18%. Conclusion: Typhoid perforation posed a major health hazard with high morbidity and mortality especially in a low socioeconomic environment where poor personal hygiene, improper human waste disposal, malnutrition, and poor social amenities exist. Despite high mortality associated with the disease, timely diagnosis, aggressive resuscitative measures as well as early surgical intervention can go a long way in reducing menace of the disease. Prevention is the most effective way of reducing this public health problem through health education and provision of adequate potable water.
Highlights
Typhoid ileal perforation is the most serious complication of typhoid fever associated with high morbidity and mortality, (Ugwu et al, 2005; Sandro, 2017)
Typhoid infection mainly spread by feco-oral route and it is associated with poor personal hygiene
Procedures done were simple by the closure of perforation in 234 (87.31%) patients harboring 267 perforations, resection and anastomosis in 21 (7.84%) patients, right hemicolectomy in 13 (4.85%)
Summary
Typhoid ileal perforation is the most serious complication of typhoid fever associated with high morbidity and mortality, (Ugwu et al, 2005; Sandro, 2017). The disease is caused by a gram negative organism salmonella typhi and paratyphi causing typhoid fever, (Raffatellu et al, 2008). Typhoid infection mainly spread by feco-oral route and it is associated with poor personal hygiene. The study retrospectively reviewed all patients diagnosed with typhoid perforation and managed in Damaturu and Potiskum District Hospitals North-Eastern Nigeria between January 2012 and December 2016. Permission for the study was granted by the Hospitals management and informed consent obtained from all patients. Information extracted from clinical and laboratory records and data analyzed using SPSS statistical analysis. Diagnosis was made based on the typical history and clinical examinations supported by radiological, laboratory investigations and confirmed by operative findings.
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