Source
Department of Surgery, Bayero University Kano, Kano, Nigeria.
Abstract
BACKGROUND:
Typhoid perforation is the most important surgical complication of typhoid enteritis and is associated with high morbidity and mortality.
AIMS AND OBJECTIVES:
To determine the pattern and outcome of management of typhoid perforation in Aminu Kano University Teaching Hospital, Kano.
METHOD:
A retrospective Analysis of patients treated for typhoid perforation over a 6-year period.
RESULTS:
There were 47 patients: 35 males and 12 females, ratio 2.9 to 1. The patients were aged 4 years to 58 years (mean 18.9 years). Typhoid perforation occurred all the year round with a peak prevalence in September; Six (12.8%) patients perforated in the first week, 29 (61.7%) second week, and 12 (25.5%) third week, of illness. Single perforation was found in 91.5% of cases, and two to three perforations in 8.5%. Surgical treatment was by simple closure in 72.3%, wedge resection in 8.5%, ileal resection in 17.1% and right hemi-colectomy in 2.1%. Of the 41 survivors (87.2%), wound infection was the most common postoperative complication in 44.7% of cases. The mortality rate was 12.8% mostly due to overwhelming sepsis.
CONCLUSION:
Typhoid perforation requiring surgical intervention is still endemic in our subregion, and emphasis should be on preventive measures such as safe drinking water and appropriate sewage disposal, and typhoid vaccination.