Typhoid Fever Presenting with Ileal Perforation and Gastric Perforation

M. M. Muhammed, K. J. Bwala, J. O. Okoruwa

Abstract

Typhoid fever is caused by Salmonella typhi and Salmonella paratyphi.
It is a disease of developing countries and is seen among people of
low socio-economic status. Patients can develop complications like
typhoid intestinal perforation which is associated with higher
mortality.
A 15-year-old female presented to the emergency pediatric unit with
fever, abdominal pain and abdominal distension. She was septic, in
respiratory distress, and had marked generalized abdominal
tenderness with guarding. An assessment of generalized peritonitis
secondary to typhoid intestinal perforation was made. She had
exploratory laparotomy with intra-operative findings of ileal
perforation and gastric perforation. She had repair of the intestinal
and gastric perforations.
Our patient presented late with concurrent use of NSAIDs and
overwhelming sepsis which likely contributed to the gastric
perforation as this is not a usual finding in patients with typhoid
intestinal perforation.
Gastric perforation is an unusual finding in patients with typhoid
intestinal perforation. Typhoid fever and its complications can be
easily prevented by the provision of safe water, proper facilities for
sanitation, and practicing good hygiene. WAJM 2024; 41 (1): 92 - 96.

KEYWORDS: typhoid fever, intestinal perforation, gastric
perforation