Outcome of Typhoid Intestinal Perforation Management in a Tertiary Hospital, North-Central Nigeria

Abstract

Background: Typhoid intestinal perforation is the most common surgical complication and a significant cause of morbidity and mortality in typhoid fever.
 Aim: To determine the treatment outcome of patients with typhoid intestinal perforation.
 Methods: A single-centre retrospective study involving retrieving case notes of all consecutive patients who had surgeries for peritonitis secondary to typhoid intestinal perforation from October 2016 to September 2017. Data were collected with a designed case report form and analysed.
 Results: Sixty-nine patients had surgeries for typhoid intestinal perforation, of which forty-five (65.2%) were males. The median (range) age of the participants was 10(4-44) years. The commonest complications were surgical site infections 49 (71%) and wound dehiscence 17 (24.6%). The median (range) post-operative hospital stay among the survivors was 13 (7 – 50) days. Enterocutaneous fistula and wound dehiscence were responsible for prolonged hospital stay (x2= 30.126, p value< 0.001 and x2= 45.777, p value< 0.001 respectively). The overall mortality rate was 19 (27.5%). Under-five children had the highest mortality rate 5/15 (33.3%). Mortality was found to be more common among females though the association was not statistically significant (p value = 0.052). Mortality was significantly associated with extended surgical procedures (p value= 0.027). 
 Conclusion: The reported cases of typhoid intestinal perforations at the study centre were high but the mortality rate was comparable to other similar studies in Nigeria. Mortality from typhoid perforation remains high, and the pathology is best prevented