[Diagnostic, therapeutic, and prognostic aspects of typhoid intestinal perforations in Dapaong, Togo].

PURPOSE

This study's aim is to describe the diagnostic, therapeutic, and prognostic aspects of typhoid intestinal perforations (TIP) at the Dapaong regional hospital (Togo).

MATERIAL AND METHODS

This retrospective study covered all patients with such perforations seen and managed in the Dapaong regional hospital's general surgery department during the 3-year period of 2009-2011.

RESULTS

There were 110 patients with TIP during the study period, and they accounted for 67.9% of the patients treated for generalized peritonitis (162 cases). Their mean age was 10.2 years. The sex-ratio was 1.4. A single perforation was present for 69 patients (62.7%) and multiple perforations for the other 41 (37.3%). Sixty (54.5%) patients underwent simple closure, 36 (32.8%) had an ileal resection and enteroanastomosis, and 14 (12.7%) had loop or double-barrelled ileostomy. The postoperative course was complicated in 26 cases (23.6%), most often by surgical site infection, seen in 19 patients (17.3%). Overall, 23 patients died during the postoperative period, for a mortality rate of 20.9%.

CONCLUSION

Typhoid intestinal perforations are the most common cause of generalized peritonitis at the Dapaong regional hospital. Most patients have only a single perforation, which is repaired by excision-suture. Their morbidity and mortality rate are high.