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Year : 2006  |  Volume : 9  |  Issue : 3  |  Page : 90-93

Typhoid intestinal perforation in sokoto, Nigeria: An unmitigated scourge in the 21st century

Department o f Surgery, Usmanu Danfodiyo U niversity Teaching Hospital, Sokoto, P.M.B. 2370, Sokoto, Sokoto State, Nigeria

Correspondence Address:
N Mbah
Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, P.M.B. 2370, Sokoto, 840001
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Background: For the Surgeon, enteric perforation Is the most dreaded com plication of typhoid fever. Despite the numerous surgical methods described for It's operative treatment , the availability of newer potent antibiotics against the pathogen, and the vast research efforts directed at combating this disease of poverty, the mortality rate from typhoid Intestinal perforation has remained dismally high. Aim: The present study was directed at Identifying the magnitud e of this surgical condition In the northwestern part of Nigeria. Method: A 5year retrospective audit (January 2001 December 2005) of all hospital admissions of typhoid enteritis seen In the Usmanu Danfodiyo University Teaching Hos pital (UDUTH), Sokoto. Cases of intestinal perforation were subsequentl y extracted and further analyzed in detail.. Results: Out of 295 cases of clinically diagnosed enteric fever, 27 (9.2%) were managed under the surgical services of the hospital for typhoid intestinal perforation. Among those who were surgicall y treated, 21 (78%) were males and 6 (22% ) were females, representing a male: female ratio of 4:1 . The modal age was the second decade. The duration of symptoms prior to hospital presentation ranged between 3 and 28 days. The average dela y In the hospital before emergency operative treatment was 2 days. All the perforations Involved the terminal Ileum of which the majority was single (56%). Simple closure was done In 78% of cases, resection and primary end-to-end anastomosis In 15% and Intestinal exteriorization In the remainder. The mortality rate was 33%. Conclusion: Besides public health measures directed at the prevention of this disease, early hospital presentation and a minimum preoperative delay after arrival may reduce the dismally high morbidity and mortality rates that still attend typhoid enteric perforation In our sub region.

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