A review of typhoid perforation in a rural African hospital.
In Wesley Guild Hospital Ilesa in the South-West region of Nigeria a retrospective study of 105 consecutive cases operated upon for typhoid perforation between January 1988 and November 2001 was carried out. The ages of the patients were between 4 to 70 years with a mean age of 19.2 +/- 8.81. There were 84 males (80%) and 21 females (20%) giving a ratio of 4:1. Diagnoses were based on clinical and radiological findings. All the patients had laparotomy after resuscitations with intravenous fluids, electrolytes replacement, broad spectrum antibiotics, Nasogastric intubation/suctioning and urethral catherterisation. There were five negative laparotomies (4.8%). Eighty patients (76.2%) had a single perforation, while the rest 20 had multiple perforations. The perforations were located between 7 cm and 100cm from the ileo-Caecal junction. Apart from the patients who had resection and primary anastomosis, 95 (90.5%) had 2 layered closure of the perforation. The most common complications were wound infections (26.7%). Intra-abdominal abscesses (9.5%) and would dehiscence (7.6%). The mortality rate was 16.2% showing a remarkable improvement in the West African Subregions.
Agbakwuru
E A
EA
Department of Surgery, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria.
Adesunkanmi
A R K
AR
Fadiora
S O
SO
Olayinka
O S
OS
Aderonmu
A O A
AO
Ogundoyin
O O
OO
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D012189:Retrospective Studies; D012424:Rural Population; D012737:Sex Factors; D014435:Typhoid Fever / Q000150:complications* / Q000401:mortality