Ajao O G
Int Surg. 1982 Oct-Dec;67(4):317-9.
Thirty-six patients were operated upon for terminal ileal perforations in a two-year period; four cases were due to trauma, four to ascariasis and 28 to typhoid. Ileal perforations due to ascaris worms are differentiated from typhoid ileal perforations because worms are usually found lying freely in the peritoneal cavity or in close association with the perforations. Also, tests for Salmonellae and Shigella are usually negative. Factors affecting mortality and morbidity in typhoid ileal perforation include the age of the patient, duration of perforation before surgery, presence of additional complications, such as massive rectal bleeding, the extent of the surgery, and the number of perforations present. Chloramphenicol in massive doses is indicated for all these patients. Our experience suggests that the hematoxicity of this drug has been over-rated. Postoperative complications are: wound infection (about 95% of cases), malarial fever, septicemia, fecal fistula, intraabdominal abscess, pulmonary infection, jaundice and transient psychosis.
在两年时间里，有36例患者因回肠末端穿孔接受了手术；其中4例由外伤引起，4例由蛔虫病引起，28例由伤寒引起。蛔虫导致的回肠穿孔与伤寒性回肠穿孔不同，因为通常可发现蛔虫自由地位于腹腔内或与穿孔紧密相连。此外，沙门氏菌和志贺氏菌检测通常为阴性。影响伤寒性回肠穿孔死亡率和发病率的因素包括患者年龄、手术前穿孔持续时间、是否存在其他并发症（如大量直肠出血）、手术范围以及穿孔数量。所有这些患者均需使用大剂量氯霉素。我们的经验表明，这种药物的血液毒性被高估了。术后并发症包括：伤口感染（约95%的病例）、疟疾热、败血症、粪瘘、腹腔内脓肿、肺部感染、黄疸和短暂性精神病。
