Predictors of mortality in children with typhoid ileal perforation in a Nigerian tertiary hospital

Talabi, Ademola Olusegun; Etonyeaku, Amarachukwu Chiduziem; Sowande, Oludayo Adedapo; Olowookere, Samuel Anu; Adejuyigbe, O

doi:10.1007/s00383-014-3592-9

Cited by 10 publications

(18 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our findings showed that when the aetiology of surgical abdomen was matched with age groups and gender of our patients, the relative frequency of the various causes was consistent with earlier reports was obtained [1][2][3][7][8][9][10][11] . Patients below five years were excluded from the study as most of them were referred directly to the specialist paediatrics surgery unit where better ancillary support [intensive care unit and paediatrics anaesthetists] services were available.…”

Section: Discussionsupporting

confidence: 91%

“…Thus surgical site infection occurring as the most common post-operative complication was not surprising in patients with intra-abdominal sepsis when compared with other causes of surgical abdomen in this study. The high rate of surgical site infection amongst patients with complicated intra-abdominal sepsis, like typhoid ileal perforation, corroborates earlier reports 8,10,11,13,15 . Furthermore patients with typhoid ileal perforation constituted the bulk of patients with post-operative complications; this may be due to the pan-systemic nature of the disease with septicaemia.…”

Section: Discussionsupporting

confidence: 89%

“…Similar late presentation by patients had been noted by researchers across diverse specialties for different disease states [8][9][10][11][12][13][14][15] . This delay had been attributed to poverty 16 and the poor health seeking behaviour of the populace 9 which may manifest as self-medication, patronage of unorthodox medical practitioners and quacks before coming to the hospital.…”

Section: Discussionsupporting

confidence: 77%

“…This could alter the temporal profile and mask clinical features of diseases; thus promoting delayed presentation and diagnosis with attendant propensity towards disease complication at presentation. Moreover, patients with surgical abdomen who present late do so in poor physiologic states: with fluid, electrolyte and acid-base imbalance [8][9][10][11][12][13][14] . Similarly, patients with surgical abdomen from trauma could have haemoperitoneum sufficient enough to cause hypovolaemic shock requiring correction.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, patients with surgical abdomen from trauma could have haemoperitoneum sufficient enough to cause hypovolaemic shock requiring correction. Judicious and expeditious correction of these deficits greatly improves surgical outcome 10,[15][16][17][18] .…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Surgical Abdomen in School Age Children: A Prospective Review From Two Centers In SouthWestern Nigeria

Etonyeaku¹,

Talabi²,

Akinkuolie³

et al. 2017

East. Cent. Afr. J. Surg.

View full text Add to dashboard Cite

Background: Surgical abdomen traverses all age groups. We sought to define the aetiology, patients' characteristics, and outcome of management amongst children Methods: Two years prospective review of patients aged 5-15 years managed for surgical abdomen at the Wesley Guilds Hospital Ilesa and Mishmael Medical Centre Akure, Nigeria. Results: Fifty two patients were treated. The male: female ratio was 1:1. The age range was 5years to 15years (mean=11.25 ±2.24years). Mean duration of illness was 29.5hours (range 2-72hours). Gut perforation was the most common aetiology (n=39; 75%); with perforations due to infections most prevalent (n= 34; 87.2%). Ten cases (19.2%) were trauma related and showed male predominance. Obstructed gut accounted for 15.4% (n=8) of cases; and showed female predominance. Five out of the eight small bowel obstructions (62.5%) were due to post operation adhesions. Pre-operative and post-operative diagnoses were congruent in 90.4% (n=47) of cases. Major post-operative complications were surgical site infection (20; 38.5%), and pneumonia (5; 9.6%). The average hospital stay was 9days (range 4-21days). Mortality rate was 1.9% (n=1). Conclusion: Acute abdomen requiring surgical intervention is mainly infective origin. The male child is more at risk of abdominal trauma while gut obstruction was more common in females.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Surgical Abdomen in School Age Children: A Prospective Review From Two Centers In SouthWestern Nigeria

Etonyeaku¹,

Talabi²,

Akinkuolie³

et al. 2017

East. Cent. Afr. J. Surg.

View full text Add to dashboard Cite

show abstract

Surgical Complications of Typhoid Fever

2020

View full text Add to dashboard Cite

Morbidity and Mortality of Typhoid Intestinal Perforation Among Children in Sub‐Saharan Africa 1995–2019: A Scoping Review

Birkhold

Coulibaly²,

Coulibaly³

et al. 2020

World j. surg.

View full text Add to dashboard Cite

Background Typhoid fever incidence and complications, including intestinal perforation, have declined significantly in high-income countries, with mortality rates \1%. However, an estimated 10.9 million cases still occur annually, most in low-and middle-income countries. With the availability of a new typhoid conjugate vaccine licensed for children and recommended by the World Health Organization, understanding severe complications, including associated mortality rates, is essential to inform country-level decisions on introduction of this vaccine. This scoping review summarizes over 20 years of the literature on typhoid intestinal perforation in sub-Saharan Africa. Methods We searched EMBASE, PubMed, Medline, and Cochrane databases for studies reporting mortality rates due to typhoid intestinal perforation in children, under 18 years old, in sub-Saharan Africa published from January 1995 through June 2019. Results Twenty-four papers from six countries were included. Reported mortality rates ranged from 4.6-75%, with 16 of the 24 studies between 11 and 30%. Thirteen papers included postoperative morbidity rates, ranging from 16-100%. The most documented complications included surgical site infections, intra-abdominal abscesses, and enterocutaneous fistulas. High mortality rates can be attributed to late presentation to tertiary centers, sepsis and electrolyte abnormalities requiring preoperative resuscitation, prolonged perforation-to-surgery interval, and lack of access to critical care or an intensive care unit postoperatively. Conclusions Current estimates of mortality related to typhoid intestinal perforation among children in sub-Saharan Africa remain unacceptably high. Prevention of typhoid fever is essential to reduce mortality, with the ultimate goal of a comprehensive approach that utilizes vaccination, improvements in water, sanitation, and hygiene, and greater access to surgical care.

show abstract

Predictors of mortality in children with typhoid ileal perforation in a Nigerian tertiary hospital

Abstract: The patients' age and postoperative burst abdomen were significant determinants of survival in children with typhoid ileal perforation.

Cited by 10 publications

References 13 publications

Surgical Abdomen in School Age Children: A Prospective Review From Two Centers In SouthWestern Nigeria

Surgical Abdomen in School Age Children: A Prospective Review From Two Centers In SouthWestern Nigeria

Surgical Complications of Typhoid Fever

Morbidity and Mortality of Typhoid Intestinal Perforation Among Children in Sub‐Saharan Africa 1995–2019: A Scoping Review

Contact Info

Product

Resources

About