Typhoid perforations of the ileum. A review of 59 cases, seen at Agogo Hospital, Ghana, between 1982 and 1987.

In Agogo Hospital in the forest zone of Ghana, 59 consecutive cases of typhoid perforation (TP) of the ileum, occurring between August 1982 and January 1987 were studied retrospectively. Perforation occurred in one patient while on admission in the hospital; all other patients presented with TP. Aneosinophilia was seen in 21/28 = 75%; pneumoperitoneum at radiography or fluoroscopy was present in 16/23 = 70%; neither test proved either satisfactorily sensitive or specific for the diagnosis of TP. In 24 out of 31 patients, ileal perforation occurred in the first week of fever. The mean time for perforation was six days after onset of fever. Late perforation was not associated with higher case fatality rate in this series. Survival was 68%, in accord with most reports on surgically treated TP. Delay in surgery over 2 days after perforation was significantly associated with higher mortality. Outcome was significantly more favourable in children than in adults.