Typhoid ileal perforations: why such mortalities?

The average mortality of 25 per cent in typhoid perforations of the ileum treated operatively could be reduced, because only half of the cases die of the lethal complications of myocarditis and toxaemia. The results of the present study show important differences between the preoperative fluid and electrolyte therapy of survivors and non-survivors as well as differences in the urinary output per hour. The perforation-operation interval as well as duration of the illness also have prognostic significance. The problem of enteric fever must ultimately be solved by preventive measures, but the results of this review indicate that attention to these factors could halve the present mortality.