Typhoid fever may be associated with perforation of the terminal ileum. A perforation usually follows necrosis and ulceration of a hypertrophic Peyer's patch in the terminal ileum. A number of factors affect the patient's outcome.
Perforation tends to occur more often in males and in children.
Risk factors for mortality:
(1) inadequate resuscitation prior to surgery
(2) delay in operative management
(3) inappropriate choice of antibiotics
(4) multiple perforations
(5) severe peritonitis with profuse exudate
Adesunkanmi and Ajao noted that most patients died within 10 days of presentation.
Complications may include:
(1) enterocutaneous fistula
(2) surgical site infection with or without wound dehiscence
(3) intra-abdominal abscess
(4) reperforation
(5) chest infection
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