Outcome of surgical treatment of intestinal perforation in typhoid fever

Abstract

Aim: To represent our clinical experience in the treatment of intestinal perforation arising from typhoid fever.

Methods: The records of 22 surgically-treated patients with typhoid intestinal perforation were evaluated retrospectively.

Results: There were 18 males and 4 females, mean age 37 years (range, 8-64 years). Presenting symptoms were fever, abdominal pain, diarrhea or constipation. Sixteen cases were subjected to segmental resection and end-to-end anastomosis, while 3 cases received 2-layered primary repair following debridement, one case with multiple perforations received 2-layered primary repair and end ileostomy, one case received segmental resection and end-to-end anastomosis followed by an end ileostomy, and one case received segmental resection and end ileostomy with mucous fistula operation. Postoperative morbidity was seen in 5 cases and mortality was found in one case.

Conclusion: Intestinal perforation resulting from Salmonella typhi is an important health problem in Eastern and Southeastern Turkey. In management of this illness, early and appropriate surgical intervention is vital.

Figure 1

Histopathologic view of typhoid lesions. A: Typhoid nodule, there are macrophages containing bacteria, red blood cells, and nuclear debris from small nodular aggregates in Peyer’s patches (HE stain, × 20 objective); B: Typhoid ulceration (HE stain, × 5 objective).