Typhoid intestinal perforations: twenty-six year experience.
BACKGROUND
Typhoid fever (TF) is a severe febrile illness caused by Salmonella typhi. One of the most lethal complications of TF is ileal perforation (TIP). Although the mortality of associated with TIP has decreased slightly over the past decade, it is still high.


RESULTS
The records of the 82 surgically treated patients with TIP were evaluated retrospectively. There were 64 men with the mean age of 36.3 years (range: 7-68 years). In surgical treatment, debridement with primary closure was performed in 32 patients (39.0%), and wedge resection with primary closure was performed in 9 (11. 0%), resection with primary anastomosis in 9 (11.0%), and resection with ileostomy in 32 (39.0%). The most common postoperative complication was wound infection, which occurred in 24 patients (29.3%). The overall morbidity was highest in the ileostomy group. The overall mortality was 11.0% (9 patients). Age, gender, number, and localization of the perforations (p > 0.05) were not found to affect mortality, but prolonged preoperative period (p < 0.001), extended peritoneal contamination (p < 0.01), and ileostomy procedure (p < 0.001) were found to influence the increase in mortality.


CONCLUSIONS
Early and appropriate surgical intervention with effective preoperative and postoperative care may improve survival in TIP.
Atamanalp
S Selcuk
SS
Department of General Surgery, Atatürk University, School of Medicine, 25070, Erzurum, Turkey. ssa@atauni.edu.tr.
Aydinli
Bulent
B
Department of General Surgery, Atatürk University, School of Medicine, 25070, Erzurum, Turkey.
Ozturk
Gurkan
G
Department of General Surgery, Atatürk University, School of Medicine, 25070, Erzurum, Turkey.
Oren
Durkaya
D
Department of General Surgery, Atatürk University, School of Medicine, 25070, Erzurum, Turkey.
Basoglu
Mahmut
M
Department of General Surgery, Atatürk University, School of Medicine, 25070, Erzurum, Turkey.
Yildirgan
M Ilhan
MI
Department of General Surgery, Atatürk University, School of Medicine, 25070, Erzurum, Turkey.
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003646:Debridement; D013505:Digestive System Surgical Procedures / Q000401:mortality; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000382:microbiology* / Q000401:mortality / Q000601:surgery*; D007081:Ileostomy / Q000009:adverse effects / Q000401:mortality; D007416:Intestinal Perforation / Q000382:microbiology* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012485:Salmonella typhi / Q000302:isolation & purification; D016019:Survival Analysis; D014421:Turkey / Q000453:epidemiology; D014435:Typhoid Fever / Q000150:complications*