Prognostic factors in typhoid ileal perforation: a prospective study of 53 cases.

Abstract

Typhoid ileal perforation remains a serious complication of typhoid enteritis with high morbidity and mortality in many tropical countries. To determine the prognostic factors in typhoid perforation in Kano, Nigeria. Fifty-three consecutive patients with typhoid perforation managed surgically were prospectively studied at the general surgical unit of Aminu Kano Teaching Hospital Kano, from March 2004 to February 2006. There were 26 (49.1%) males and 27 (50.9%) females, with age range of 2-55 years and a mean +/- SD of 12.2 +/- 10.2 years. The morbidity was 49.1% and the most common postoperative complications included wound infection, wound dehiscence, burst abdomen, residual intra-abdominal abscesses and enterocutaneous fistula. Mortality was 15.1% and was significantly affected by multiple perforations, severe peritoneal contamination and burst abdomen (p value 1). The mean duration of hospital stay for survivors was 16.1 days with a range of 8-57 days. This study has attempted to determine the factors that statistically influence mortality in typhoid perforation in our environment.