Affiliations: Department of General Surgery, Institute of Medical
Sciences, Banaras Hindu University, Varanasi, India
Note: [] Correspondence: Prof. Ajay K. Khanna, MS, FACS, Department of
General Surgery, Institute of Medical Sciences, Banaras Hindu University,
Varanasi, India – 221 005. Tel.: +91 542 2318418; Fax: +91 542 2367568;
E-mail: [email protected]; [email protected]
Abstract: Today there are as many as 16–30 million cases of enteric fever per
year, almost exclusively in the developing world caused mainly by unhygienic
conditions and poor sanitations, with a mortality rate of 10%. Typhoid fever
is important surgically because abdominal complications such as intestinal
perforation, bleeding, cholecystitis and pancreatitis represent the most
serious complications of the illness. Typhoid perforation of the ileum is one
of the most common causes of bowel perforation in the developing world. This
review will focus on surgical complications and management in children.
Persistent or severe enteric fever usually culminates in some surgical
complications in the form of hemorrhage, perforation, cholecystitis,
pancreatitis, hepatitis, abscess etc. Morbidity and mortality are significantly
high in children than in adults. Timely and proper surgical intervention are
pivotal in reducing morbidity and mortality from surgical complications of
enteric fever. Hypovolemia and sepsis must be corrected by hydration and
antibiotics followed by definitive treatment of the underlying complication.
Enteric fever continues to be a menace for children in third world countries.
Underestimated incidence is due to the lack of a simple diagnostic test for
enteric fever. Perforations and hemorrhage are the complications to be managed
meticulously. Early diagnosis of perforation and surgical intervention reduces
morbidity as well as mortality.
