title: Single-layer closure of typhoid enteric perforation: Our experience.
abstract: BACKGROUND
  Typhoid enteritis is rare in developed countries. The increasing prevalence of typhoid fever with enteric perforation in our environment is alarming. Peritonitis follows enteric perforation due to typhoid enteritis. Surgical treatments and repair of the perforated areas due to typhoid enteritis varies between institutions with high mortality and morbidity.
  
  
  METHODS
  We retrospectively studied the effects of single versus double layer intestinal closure after typhoid enteric perforation with peritonitis in 902 pediatric patients from September 2007 to April 2012. All the patients underwent laparotomy after resuscitation and antibiotic cover. The patients were divided into two groups: group A (n = 454) double layer closure and group B (n = 448) single layer closure.
  
  
  RESULTS
  There were 554 males and 348 females with male to female ratio 1.6:1. Ages of the patients were three years to 14 years with mean age at eight years and mode at nine years. The following clinical outcomes were recorded: burst abdomen 38 (8.3%) vs 3 (0.6%), enterocutaneous fistula formation 52 (11.4%) vs 8 (1.7%), superficial wound infection 215 (47.3%) vs 91 (20.3%), ligature fistula 13 (2.8%) vs 7 (1.5%), mean length of 29.4 ± 7.8 vs 45.3 ± 11.6.
  
  
  CONCLUSIONS
  Our results showed that single layer closure of the perforated ileum due to typhoid enteric perforation with peritonitis in children was effective by reducing complication rates.
authors.affiliation: Department of Surgery, Murtala Muhamad Specialist Hospital, Children Surgical Unit, Kano, Nigeria. zarenawa1@yahoo.com
authors.forename: Musa
authors.initials: M
authors.lastname: Ibrahim
authors.forename: K I
authors.initials: KI
authors.lastname: Getso
authors.forename: A H
authors.initials: AH
authors.lastname: Yashuwa
authors.forename: A M
authors.initials: AM
authors.lastname: Mohammad
authors.forename: L J C
authors.initials: LJ
authors.lastname: Anyanwu
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007416:Intestinal Perforation / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007813:Laparotomy / Q000379:methods*; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013536:Suture Techniques; D016896:Treatment Outcome; D014435:Typhoid Fever / Q000150:complications / Q000401:mortality / Q000601:surgery*