Isolated Rectal Perforation Presenting as Peritonitis in a Child with Enteric Fever

Chaubey, Digamber; Verma, Ajay Kumar; Pandey, Anand; Gupta, Archika

doi:10.1055/s-0037-1606571

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…In our study, we found 8/13 cases of ileal perforation and one case of acute intestinal obstruction with impending multiple ileal perforations; if we include this as perforation, total 9/13 cases of ileal perforation and four cases of atypical sites of perforation. Review of relevant literature during our study revealed sporadic case reports of multiple typhoid, ileal and cecal perforations [12]; few cases of Caecal [14], sigmoid [15] and rectal [16] perforation but typhoid gastric perforation could not be found. Also, there is no reporting of combined jejunoileal perforations along with Meckel's band obstruction and Meckel's diverticular perforation.…”

Section: Discussionmentioning

confidence: 69%

Review of Paediatric Typhoid Perforation Cases Managed at a Tertiary Care Centre

Chaubey

Rahul

Yadav

et al. 2020

JAMMR

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Background: Any criteria (clinical, pathologic, microbiological or histo-pathologic) attributing a case of Paediatric gastrointestinal perforation to Typhoid would be of help in reaching a proper diagnosis to guide appropriate management. Aims and Objectives: To review all cases of Typhoid perforation for their clinical, pathologic and intra-operative findings. Materials and Methods: A retrospective study was conducted on all cases of typhoid perforation (gastrointestinal perforation with positive Widal test) operated at a tertiary care centre from September 2015 to September 2018. Data regarding their clinical findings, investigation results, intraoperative findings, nature of the surgical intervention, postoperative results and histopathological findings were collected from their records and analysed. Results: A total of 13 patients were operated during this period with positive Widal’s test at presentation. 6/13 had single ileal perforation; two patients had multiple ileal perforations; perforation at atypical sites were found in four patients (one each at gastric, duodenal, caecal and rectal); one patient presented with Meckel’s band obstruction with multiple ulcers – this patient was sick and died despite a diverting ileostomy in the postoperative period. While 8/13 patients had primary closure of the perforation site, diversion through ileostomy was performed in five patients. All patients did well in the post-operative period except one patient of multiple ulcers and obstructing Meckel’s band who died in the post-operative period. Conclusion: On encountering a gastrointestinal perforation, no definite symptomatology or its pattern, no clinical examination findings, no intraoperative characteristics of the perforation and no biopsy can definitively point towards Typhoid as the cause. Therefore, we still have to depend on serological tests in correlation with clinical features to reach a conclusive diagnosis. Cultures and PCR, although sensitive are either time-taking or expensive to guide management. Typhoid perforation can have vivid and atypical presentation depending on the number and site of perforation.

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Section: Discussionmentioning

confidence: 69%

Review of Paediatric Typhoid Perforation Cases Managed at a Tertiary Care Centre

Chaubey

Rahul

Yadav

et al. 2020

JAMMR

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“…In our patient’s case, the perforation occurred in the antimesenteric surface of rectum, which is rare in children. However, there is a report of isolated rectal perforation in a 3-year-old girl with enteric fever [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rectosigmoid perforation at the watershed area of the Sudeck point in an apparently healthy toddler boy: a case report

Solomon,

Habte,

Alemu

et al. 2023

J Med Case Reports

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Background Spontaneous colon perforation can be classified into stercoral and idiopathic. Stercoral type is associated with chronic constipation, thus it is rare in infants and children. The idiopathic type is sporadic and could occur at any age. Delay in diagnosing or treating idiopathic colon perforation is associated with high mortality and morbidity rates. There are few studies on rectal perforation related to other etiologies or past the neonatal period, and their effect on disease onset and prognosis are unknown. Case presentation We report on a case of 2-year-and-5-month-old Oromo boy who presented with fever, diarrhea, vomiting, and progressive abdominal pain of 5-day duration. The boy underwent an exploratory laparotomy for suspected peritonitis and there was a single perforation of approximately 2.0 cm size in the anterior part of the upper one-third of rectum. The perforated rectum was repaired primarily and sigmoid divided diversion colostomy was carried out. Conclusion It is important to be aware of idiopathic colon perforation in children, a rare but dangerous condition with high mortality and morbidity in cases of delayed diagnosis or management. Pediatricians and surgeons should consider colon perforation as a cause in children who present with abdominal distention and a history of diarrhea for more than 5 days.

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Isolated Rectal Perforation Presenting as Peritonitis in a Child with Enteric Fever

Cited by 2 publications

References 13 publications

Review of Paediatric Typhoid Perforation Cases Managed at a Tertiary Care Centre

Review of Paediatric Typhoid Perforation Cases Managed at a Tertiary Care Centre

Spontaneous rectosigmoid perforation at the watershed area of the Sudeck point in an apparently healthy toddler boy: a case report

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