Typhoid intestinal perforation: Analysis of the outcome of surgical treatment in Kano, Nigeria

Background: Intestinal perforation is a serious complication of typhoid fever with high case fatality rates in developing countries. This study aims to determine the factors associated with an adverse clinical outcome among patients managed for typhoid intestinal perforation (TIP) in our hospital. Materials and Methods: We retrospectively reviewed the records of all patients presenting to our general surgery unit with TIP between January 2012 and December 2015. The patients were categorized based on postoperative outcome status and the patient-related variables were compared and analyzed for determinants of outcome, using the Chi-square test. A statistical significance was assigned to a P Results: There were fifty patients who had surgery for TIP during the study period, but only the records of 47 patients could be retrieved for analysis. Of these, 32 (68.1%) were males and 15 (31.9%) were females. The male/female ratio was 2.13:1. Their ages ranged from 13 to 55 years with a median of 17 years. A single intestinal perforation was seen in 87.2% (41/47), while 12.8% (6/47) had two or more. The mortality rate was 8.5% (4/47). The occurrence of a postoperative fecal fistula was significantly ( P = 0.016) associated with a postoperative mortality. A peritoneal aspirate volume u003e1000 ml was significantly associated with having a postoperative fecal fistula ( P = 0.011) and postoperative mortality ( P = 0.002). A number of intestinal perforations were not significantly associated with an adverse outcome ( P u003e 0.05). Conclusion: Postoperative fecal fistula adversely affected the outcome of the patients in our series. Multiple intestinal perforations did not seem to affect the outcome in our patients.