To Evaluate the Prognostic Factors Involved in Cases of Intestinal Perforation Caused by Typhoid Fever.

Shua Haq, Mahnoor Irshad, Zainab Zaman

Abstract


Objective: The main aim of this study was to evaluate the prognostic factors involved in cases of intestinal perforation caused by typhoid fever.

Place and Duration of Study: This study was carried out in North Surgical Department of Mayo Hospital Lahore from January 2018 to November 2018.

Materials and Methods: A total of 62 patients were selected for the study who were diagnosed with intestinal perforation due to typhoid fever. Diagnosis was made on clinical basis and with the help of Widal test. X-ray abdomen erect and supine was obtained which showed air under diaphragm. Patients were initially resuscitated and exploratory laparotomy was done which showed perforation in the small intestine. Patients were kept in HDU and vitals were monitored 4 hourly and data of each patient was recorded in predesigned proforma.

Results: Out of total 62 patients 20% were female patients while 80% were male patients. Single perforation was seen in 84% of the cases while multiple perforation were seen in 16% of the patients. Wound dehiscence, wound infection, septicemia, residual abscess and fecal fistula like complications were seen in 80% of the patients. Mortality was increased by number of factors which included delayed surgery, excessive fecal material, delayed presentation to hospital and multiple perforations. The death rate was around 17.7% (11/62). 

Conclusion: Septicemia, excessive abdominal fluid, fecal fistula, multiple perforations, duration of operation, mortality, duration of disease and rupture of abdomen are greatly affected by typhoid related intestinal perforation. Long hospital stay is seen in some cases in which wound gets infected and with the presence of fecal fistula.

Keywords: Prognostic factors, mortality, intestinal typhoid perforation.


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