Typhoid Intestinal Perforation in Central India A Surgical Experience Of 155 Cases in Resource Limited Setting

Abstract

Introduction: Typhoid fever is a major public health problem in developing countries of Africa and Asia. India has highest incidence worldwide. Our purpose of conducting this study was to reveal our clinical experience in surgical management of enteric perforation. Materials and Method: It is a retrospective study of patients who were operated for typhoid intestinal perforation at Bundelkhand Medical College and Associated District Hospital, Sagar, India, between August 2008 and October 2013; after approval from institutional ethics committee this study was started. The data of patients who were presented with typhoid perforation was retrieved from medical records department of hospital. In all cases Widal test was positive for typhoid. Laparotomy was performed by midline incision. Management of perforation was dependant on the type of severity of disease. Results: Various type of surgical repair techniques were applied on the basis of number of perforations, degree of contamination, shock, presence of other co-morbid conditions. 34 patients underwent reoperation, 119 (76.77%) patients had post-operative complication with the most common complication being the surgical site infection. The median hospital stay was 21.56 days. Patients who had postoperative complication stayed longer in the hospital. In our study the mortality rate was 15.48%.