Ouedraogo S, Ouangre E, Zida M
Université de Ouagadougou, BP 56 Ouagadougou, Burkina Faso.
Med Sante Trop. 2017 Feb 1;27(1):67-70. doi: 10.1684/mst.2017.0661.
The aim of this study was to describe the epidemiological, clinical, and therapeutic features of ileal perforation due to typhoid fever at the regional hospital of Tenkodogo (Burkina Faso). This cross-sectional study examined the records over a 5-year period of all patients treated for typhoid ileal perforation. Ileal perforation was diagnosed intraoperatively, and its typhoid origin determined according to the following criteria : background signs of typhoid fever, location of the perforation on the antimesenteric edge of the terminal ileum, and a positive Widal-Felix serology. The study included 216 patients. Their mean age was 13.8 years, and 63.4% were male. The average time to consultation was 11 days. Clinical signs were mainly abdominal pain, vomiting, and abdominal tenderness. Anemia was observed in 135 patients (62.5%). All patients underwent laparotomy. Three procedures for treating surgical perforation were used : excision and suture of the perforation in 86 patients (39.8%), ileal resection with anastomosis in 98 (45.4%), and ileostomy with subsequent recovery in 32 (14.8%). The average length of hospital stay was 16.1 days. Postoperative complications occurred in 156 patients (72.2%). Thirty-seven patients died, for a mortality rate of 17.1 %. Ileal perforations due to typhoid fever are the main cause of peritonitis in rural areas of Burkina Faso. Patients are relatively young, and most are anemic at admission. Morbidity and mortality are significant.
本研究旨在描述布基纳法索滕科多戈地区医院伤寒热导致回肠穿孔的流行病学、临床和治疗特征。这项横断面研究检查了5年间所有因伤寒性回肠穿孔接受治疗的患者的记录。回肠穿孔在术中诊断，其伤寒起源根据以下标准确定：伤寒热的背景体征、穿孔位于回肠末端对系膜缘的位置以及肥达-费利克斯血清学阳性。该研究纳入了216名患者。他们的平均年龄为13.8岁，63.4%为男性。平均就诊时间为11天。临床体征主要为腹痛、呕吐和腹部压痛。135名患者（62.5%）出现贫血。所有患者均接受了剖腹手术。采用了三种治疗手术穿孔的方法：86例患者（39.8%）行穿孔切除缝合术，98例（45.4%）行回肠切除吻合术，32例（14.8%）行回肠造口术并随后恢复。平均住院时间为16.1天。156例患者（72.2%）发生术后并发症。37例患者死亡，死亡率为
