Journal of Clinical and Diagnostic Research. 2013 Sept, Vol-7(9): 1946-1948 1946 1946 DOI: 10.7860/JCDR/2013/6632.3366 Original Article

Pujar, K A

doi:10.7860/jcdr/2013/6632.3366

Cited by 4 publications

(6 citation statements)

References 17 publications

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“…The mechanism whereby infection results in perforation is due to bacterial attachment and invasion, causing subsequent hyperplasia and necrosis of the immune sentinel microfold cells, anatomically visible in Peyer’s patches. 6 The usual site of perforation is at the anti-mesenteric border of the ileum; however, other sites can also be affected such as the cecum, jejunum, colon, 1 and, occasionally, the appendix. 16 This report describes a case of ileal perforation due to S. Typhi infection detected during passive surveillance at our field site in Dhaka, Bangladesh.…”

Section: Discussionmentioning

confidence: 99%

“…Ileal perforation is one of the most fatal and common complications of typhoid fever, 1 which is a public health concern in many low-resource settings. 2 Estimates of typhoidal intestinal perforation (TIP) incidence in developed and resource-poor countries vary widely from 0.8% to 39%, 3 – 6 likely because of 1) nonstandardized case definitions, 2) poor reporting or surveillance systems, and 3) lack of clinician awareness.…”

Section: Introductionmentioning

confidence: 99%

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Case Report: Typhoid Fever Complicated by Ileal Perforation in an Urban Slum of Dhaka, Bangladesh

Khanam

Darton

Ross

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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Intestinal perforation is one of the most dangerous complications of typhoid fever and demands urgent hospitalization, diagnosis, and surgical management to reduce morbidity and prevent mortality. Here, we report a case of typhoidal intestinal perforation in a 19 year-old young man detected by passive surveillance during a cluster-randomized trial with Vi-tetanus toxoid conjugate vaccine (Typhoid Vaccine Acceleration Consortium: TyVAC) in an urban slum area in Mirpur, Dhaka, Bangladesh. The patient presented with a high-grade fever, lower abdominal pain, and vomiting and was admitted to a healthcare facility. Physical examination and preoperative investigations of the patient suggested a presumptive diagnosis of intestinal perforation, and the patient was transferred to a tertiary-level hospital for surgical management. A positive blood culture, intraoperative findings, and histopathology of an intestinal biopsy confirmed ileal perforation due to typhoid fever. This case report highlights the need for prompt diagnosis and appropriate pre- and postoperative management of patients who appear with the symptoms of typhoidal intestinal perforation. This report further demonstrates the importance of systematic surveillance and proper evaluation to determine the true incidence rate of typhoid fever and intestinal perforation in Bangladesh.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Case Report: Typhoid Fever Complicated by Ileal Perforation in an Urban Slum of Dhaka, Bangladesh

Khanam

Darton

Ross

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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“…In differential analysis of relative contributors to death toll, our study clearly points complications of typhoid fever as a major problem. Over the past two decades, the trend of mortality of this type of peritonitis has been on the decline [ 16 , 53 , 54 ]. Such reduction can only be achieved by early recognition and diagnosis, timely surgical intervention, appropriate antibiotics and surgical technique and peri-operative care which all play a key role in reducing mortality in typhoid intestinal perforation [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

“…Over the past two decades, the trend of mortality of this type of peritonitis has been on the decline [ 16 , 53 , 54 ]. Such reduction can only be achieved by early recognition and diagnosis, timely surgical intervention, appropriate antibiotics and surgical technique and peri-operative care which all play a key role in reducing mortality in typhoid intestinal perforation [ 53 ]. Also, policies on typhoid vaccine and public health education may help to reduce morbidity and mortality due to this endemic disease [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Which cause of diffuse peritonitis is the deadliest in the tropics? A retrospective analysis of 305 cases from the South-West Region of Cameroon

2016

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BackgroundAcute diffuse peritonitis is a common surgical emergency worldwide and a major contributor to non-trauma related death toll. Its causes vary widely and are correlated with mortality. Community acquired peritonitis seems to play a major role and is frequently related to hollow viscus perforation. Data on the outcome of peritonitis in the tropics are scarce. The aim of this study is to analyze the impact of tropic latitude causes of diffuse peritonitis on morbidity and mortality.MethodsWe retrospectively reviewed the records of 305 patients operated on for a diffuse peritonitis in two regional hospitals in the South-West Region of Cameroon over a 7 years period. The contributions of various causes of peritonitis to morbidity and mortality were analyzed.ResultsThe diagnosis of diffuse peritonitis was suggested on clinical ground only in more than 93 % of cases. The most common causes of diffuse peritonitis included peptic ulcer perforation (n = 69), complications of acute appendicitis (n = 53) and spontaneous perforations of the terminal ileum (n = 43). A total of 142 complications were recorded in 96 patients (31.5 % complication rate). The most common complications included wound dehiscence, sepsis, prolonged paralytic ileus and multi-organ failure. Patients with typhoid perforation of the terminal ileum carried a significantly higher risk of developing a complication (p = 0.002). The overall mortality rate was 15.1 %. The most common cause of death was septic shock. Differential analysis of mortality of various causes of peritonitis indicated that the highest contributors to death toll were typhoid perforation of terminal ileum (34.7 % of deaths), post-operative peritonitis (19.5 %) and peptic ulcer perforation (15.2 %).ConclusionThe diagnosis of diffuse peritonitis can still rely on clinical assessment alone in the absence of sophisticated imaging tools. Peptic ulcer and typhoid perforations are still major contributors to death toll. Patients presenting with these conditions require specific attention and prevention policies must be reinforced.

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“…Typhoid fever is a severe infectious disease caused by the Gram-negative enteric bacillus Salmonella typhi [ 1 , 2 ]. Intestinal perforations are the most frequent cause of typhoid-related morbidity and mortality [ 2 – 7 ]. These lesions commonly occur in the ileum [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Bowel Resection and Ileotransverse Anastomosis as Preferred Therapy for 15 Typhoid Ileal Perforations and Severe Peritoneal Contamination in a Very Elderly Patient

Kadia¹,

Aroke

Abanda³

et al. 2017

Case Reports in Surgery

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Typhoid ileal perforation (TIP) is the most lethal complication of typhoid fever. Although TIP is a surgical emergency by consensus, there is still much controversy regarding the most appropriate surgical approach to be used. Bowel exteriorization and secondary closure are usually recommended for patients presenting late with multiple TIPs and heavy peritoneal soiling. We, however, discuss a unique case of an 86-year-old patient with 15 typhoid ileal perforations successfully treated with one-step surgery comprising bowel resection and ileotransverse anastomosis in a resource-constrained setting of Cameroon.

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Journal of Clinical and Diagnostic Research. 2013 Sept, Vol-7(9): 1946-1948 1946 1946 DOI: 10.7860/JCDR/2013/6632.3366 Original Article

Cited by 4 publications

References 17 publications

Case Report: Typhoid Fever Complicated by Ileal Perforation in an Urban Slum of Dhaka, Bangladesh

Case Report: Typhoid Fever Complicated by Ileal Perforation in an Urban Slum of Dhaka, Bangladesh

Which cause of diffuse peritonitis is the deadliest in the tropics? A retrospective analysis of 305 cases from the South-West Region of Cameroon

Bowel Resection and Ileotransverse Anastomosis as Preferred Therapy for 15 Typhoid Ileal Perforations and Severe Peritoneal Contamination in a Very Elderly Patient

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