Abstract
The results of the surgical management of 161 cases of ileal perforation due to typhoid fever are presented. Most were seen after an illness of 2-4 weeks, and because of delays in seeking hospital admission, more than half were explored more than 24 hours after their perforation occurred. All patients were prepared for operation with nasogastric suction, intravenous fluids, and antibiotics. At laparotomy, 80% had considerable quantities of pus and small bowel contents in the peritoneal cavity and the remainder had localized abscesses; there were no instances of localization of the perforation. One hundred three of these patients underwent simple closure of their perforations, while 43 underwent small bowel resection, usually because of multiple perforations. Exteriorization or drainage were performed only in patients too sick to tolerate a more appropriate procedure. The overall mortality was 9.9%. The authors believe that typhoid perforations can best be dealt with at operation. Delay in operative intervention adversely affects the survival rate after surgery. Chloramphenicol is used as the drug of choice.
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- Abdel-meneim R. I. Surgical management of perforated thyphoid ulcer. Int Surg. 1969 Nov;52(5):405–407. [PubMed] [Google Scholar]
- Boulvin R. Les péritonites par perforation typhique en Iran. Ann Chir. 1965 Jun;19(11):785–789. [PubMed] [Google Scholar]
- CONROY J. V. Acute ileitis with ulceration and perforation due to paratyphoid fever; report of eighty-five cases. Mil Med. 1957 Feb;120(2):79–92. [PubMed] [Google Scholar]
- Carayon A., Lasserve C. T., de Jaureguiberry A., Courbil J. L. A propos de 98 perforations typhiques. Mem Acad Chir (Paris) 1965 Nov 10;91(28):932–936. [PubMed] [Google Scholar]
- DICKSON J. A., COLE G. J. PERFORATION OF THE TERMINAL ILEUM. A REVIEW OF 38 CASES. Br J Surg. 1964 Dec;51:893–897. doi: 10.1002/bjs.1800511207. [DOI] [PubMed] [Google Scholar]
- Dawson J. H. Surgical management of typhoid perforation of the ileum. Am Surg. 1970 Oct;36(10):620–622. [PubMed] [Google Scholar]
- HUCKSTEP R. L. Recent advances in the surgery of typhoid fever. Ann R Coll Surg Engl. 1960 Apr;26:207–230. [PMC free article] [PubMed] [Google Scholar]
- LI F. W. SURGICAL TREATMENT OF TYPHOID PERFORATION OF THE INTESTINE. Br J Surg. 1963 Nov;50:976–979. doi: 10.1002/bjs.18005022710. [DOI] [PubMed] [Google Scholar]
- Le Peltier P. Perforations typhiques et perforations iléales. Med Trop (Mars) 1971 Jul-Aug;31(4):417–425. [PubMed] [Google Scholar]
- ROWLAND H. A. The complications of typhoid fever. J Trop Med Hyg. 1961 Jun;64:143–152. [PubMed] [Google Scholar]
- WOODWARD T. E., SMADEL J. E. MANAGEMENT OF TYPHOID FEVER AND ITS COMPLICATIONS. Ann Intern Med. 1964 Jan;60:144–157. doi: 10.7326/0003-4819-60-1-144. [DOI] [PubMed] [Google Scholar]