A Comparative Study of Typhoid and Non Typhoid Small Bowel Perforations
Journal Title: Journal of Chalmeda AnandRao Institute of Medical Sciences - Year 2017, Vol 14, Issue 2
Abstract
Introduction: Small Bowel perforations are an important cause of acute abdomen and peritonitis in developing nations. Typhoid fever is the commonest cause in tropical countries, while malignancy and mechanical causes are most common in the west. Aim and Objectives: The aim of our study was to determine the causes of small bowel perforations and to compare the outcome in patients with typhoid non-typhoid small bowel perforations. Materials and Methods: This comparative, analytic study was conducted in the Department of Surgery, CAIMS, Karimnagar, between September 2015-2017. Total 56 patients were included in this study. All patients with small bowel perforation who underwent surgical closure of a full thickness small intestinal breach and who satisfied the inclusion criteria were analyzed and followed up until their discharge from hospital or death. Results: The age of the patients in this study ranged from 9 to 65 years with a mean of 32.54± 13.58 years. Small bowel perforations commonly occurred in the third and fourth decades of life with 55.35% of patients being in that age group. Male to female ratio was 4:1.Typhoid small bowel perforation commonly occurred in second and third decades of life with a mean of 25.12± 11.56 years. Non-typhoid small bowel perforations commonly occurred in the third and fourth decades of life with mean of 35.29± 14.62. Traumatic perforations were found only in men. Twenty one men (37.5%) and 4 women (7.1%) had typhoid small bowel perforations. Conclusion: We conclude, therefore, that widal and blood cultures alone are not sufficient to diagnose typhoid small bowel perforations. Other tests like DOT EIA, tissue biopsy culture would help to increase diagnostic yield. There appears to be a definite entity of non-specific small bowel perforation, which cannot be attributed to any other cause. Complication rates are much higher in typhoid small bowel perforation.
Authors and Affiliations
Mangilal V, Venkat Ramana N, Suryanarayana Reddy V, Manasa M, Amar C Sajjan
Keywords
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