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Non-traumatic ileal perforation: a retrospective study.
[typhoid]
To
determine
clinical
features
,
operative
findings
and
post-operative
complications
in
patients
operated
for
non-traumatic
ileal
perforation
and
to
discuss
the
role
of
typhoid
vaccination
.
A
retrospective
study
was
carried
out
from
2009
-
2010
.
Seven
patients
were
admitted
through
casualty
as
cases
of
acute
abdomen
.
Underlying
conditions
were
typhoid
ulcers
(
4
patients
)
and
non-
specific
etiology
(
3
patients
)
.
Diagnosis
was
made
on
clinical
grounds
,
laboratory
investigations
,
radiology
and
operative
findings
.
Exploratory
laporotomy
was
done
.
Different
variables
studied
post-operatively
were
wound
infection
,
residual
abscess
,
recurrence
and
delayed
post-operative
complications
.
Tenderness
,
distension
and
rigidity
were
found
in
maximum
patients
.
Gases
under
diaphragm
and
air
fluid
levels
were
common
radiological
findings
.
However
,
widal
test
and
blood
culture
for
S
.
typhi
was
positive
in
four
patients
.
Six
patients
had
single
perforation
and
one
patient
had
two
perforations
,
all
being
on
antimesentric
border
of
ileum
.
Maximum
patients
had
peritoneal
collection
of
less
than
1000
ml
.
In
five
patients
simple
closure
of
perforation
was
done
and
in
remaining
two
resection
with
end
to
side
ileotransverse
anatomosis
was
required
.
Wound
infection
and
residual
intraabdominal
abscess
were
found
in
one
patient
each
.
Management
criteria
remain
same
in
typhoid
and
non-
specific
perforations
.
Commonest
cause
of
ileal
perforation
is
typhoid
fever
in
our
country
,
so
immunization
against
typhoid
beyond
18
years
of
age
is
recommended
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated