TyphicIleal Perforation at Kati Chu-BSS for Diagnostic and Therapeutic Aspects (Mali)

Abstract

Ileal perforation of typhus origin is a common and serious complication of typhoid fever in tropical environments. It is one of the main causes of morbidity in surgery in Mali. However, it would be preventable if salmonellosis were properly managed upstream, and if our living environments were cleaned up. The purpose of this study is to report on the experience of the Kati UHC General Surgery Department in the management of peritonitis by typhic perforation and to assess its prognosis. Patients and Method: This is a retrospective descriptive study that took place from January 2007 to December 2020 in the General Surgery department of the Hospitalo-University BSS Center of Kati (Mali). We have included patients who have undergone peritonitis with confirmed typhic ileal perforation with laparotomy. The other etiologies of peritonitis by ileal perforation were not retained. Results: In 14 years, we collected 89 cases of peritonitis by typhic ileal perforation. It accounted for 3.14% (89/2829) of surgical procedures, 37.5% (89/1181) of visceral surgical emergencies and 27.6% (89/322) of all acute peritonitis causes combined. There were 70 men against 29 women; the sex ratio was 2.4 with an average age of 25.8 years (extremes 8 years to 65 years). Anastomosis resetions (ileo ileal and ileocolic) predominated in 71.8% of patients. However, the ileo stoma was performed in 5.6%. A significant relationship (p 0.05) was observed between high mortality and MPI score > 26. Morbidity was 39.4% with mortality of 15.7%. The average length of stay in hospital was 12.2 days. Conclusion: Typhoid ileal perforation is common in young male adolescents in visceral surgery. This pathology generates significant morbidity. However with the extension of hand washing after Ebola disease its frequency has dropped.