Publication: Results of typhoid perforation management: Our experience in Bir Hospital, Nepal
Date
2006
Authors
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Journal ISSN
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Publisher
Kathmandu University
Abstract
Objective: To determine the demographic characteristics, clinical features, operative findings and postoperative
complications in patients operated for typhoid enteric perforation.
Methods: A retrospective study was carried out in the Department of General Surgery, Bir Hospital since 2002 to
April 2004. Among 189 patients who underwent laparotomy for hollow viscus perforation in two years, ileal
perforation was found in 102 patients.
Results: The sex ratio of the patients was 4.66:1, in favor of male, with age range of 14-78 years and mean age
28.35 years. Most of the patients (80.39 %) presented with history of fever for two weeks. Half of the patients
presented within 24 hours of onset of generalized abdominal pain. Majority (65.67%) had a solitary perforation on
the antimeseteric border of terminal ileum. Eighty one percent of patients had trimming of the ulcer margins and
primary closure. Complications included wound infection (35.3%), wound dehiscence (17.6%), fecal fistula (7.84%)
and hospital mortality (6.86%).
Conclusion: Typhoid ulcer perforation is common among developing nations, including Nepal. Postoperative
complications following surgical management of perforation are high and increases mortality.
Key words: Typhoid perforation, wound dehiscence, hospital mortality