Epidemiological, clinical, and therapeutic features of typhoid intestinal perforation in a rural environment of Burkina Faso.

The aim of this study was to describe the epidemiological, clinical, and therapeutic features of ileal perforation due to typhoid fever at the regional hospital of Tenkodogo (Burkina Faso). This cross-sectional study examined the records over a 5-year period of all patients treated for typhoid ileal perforation. Ileal perforation was diagnosed intraoperatively, and its typhoid origin determined according to the following criteria : background signs of typhoid fever, location of the perforation on the antimesenteric edge of the terminal ileum, and a positive Widal-Felix serology. The study included 216  patients. Their mean age was 13.8 years, and 63.4% were male. The average time to consultation was 11 days. Clinical signs were mainly abdominal pain, vomiting, and abdominal tenderness. Anemia was observed in 135 patients (62.5%). All patients underwent laparotomy. Three procedures for treating surgical perforation were used : excision and suture of the perforation in 86 patients (39.8%), ileal resection with anastomosis in 98 (45.4%), and ileostomy with subsequent recovery in 32 (14.8%). The average length of hospital stay was 16.1 days. Postoperative complications occurred in 156 patients (72.2%). Thirty-seven patients died, for a mortality rate of 17.1 %. Ileal perforations due to typhoid fever are the main cause of peritonitis in rural areas of Burkina Faso. Patients are relatively young, and most are anemic at admission. Morbidity and mortality are significant.