Articles

Prevalence of Intestinal Perforation Due to Typhoid Fever in the General Surgery Department of Nangarhar Regional Hospital

Typhoid is a systemic disease caused by S. Typhi and S. Paratyphi, and its specific clinical features include fever, abdominal pain, diarrhea and nausea. Typhoid is still a major problem in developing countries, mostly caused due to poor sanitation and improper drainage system.

This study is conducted in descriptive form, and all the patients admitted to the General Surgery Department of Nangarhar Regional Hospital had intestinal perforation due to typhoid. The number of patients was 30, who were included in this research. To diagnose the disease, radiological and laboratory tests were done.

The results of the research showed that the incidence of intestinal perforation due to typhoid was (3.3%) in less than 10 years old, 26.6% in the group age 11-20 years old, 23.3% were 21-30 years old, 13.3% in 31-40 years old, 13.3% in 41-50 years old, 13.3% in 51-60 years old and 6.9% were the patients had more than 60 years of age. The occurrence of incidence was based on sex, 18 cases (60%) were male, and 12 cases (40%) were female patients. After the analysis and interpretation of the data, it was found that the ratio of cases in males was higher than in females. According to the clinical record, 100% of the patients had abdominal pain and fever, 80% had abdominal distension, 36.6% had vomiting, 16.6% had diarrhea, and 13.3% had constipation. The results of diagnosis of typhoid-based examination, the cases by abdominal x-ray were 90% and ultrasound 83.4%. Based on the results, it is clear that the abdominal x-ray gave better results than the ultrasound. It is worth mentioning that the incidence of intestinal perforation was 96.6% in the distal ileum and 3.4% in the jejunum.

In conclusion, stomach pain, fever, and abdominal distension were more common than all other symptoms in cases of intestinal perforation due to typhoid. The most important method for diagnosis is an abdominal X-ray, and most cases occur in the terminal part of the ileum.