Typhoid perforation occurs during
• Enteric fever is a potentially life - threatening systemic disease characterized by fever and abdominal pain.
• It is caused by Salmonella typhi or paratyphi.
• Typhoid is the MC cause of ileal perforation in tropical countries (India).
Pathology :
• Ulceration and necrosis of ileocecal Peyer’s patches.
• The ulcer is parallel to the long axis of the gut and is usually situated in the lower ileum (longitudinal ulcers).
• Perforation of a typhoid ulcer usually occurs during the third week and is occasionally the first sign of the disease.
Clinical Features :
• Fever and abdominal pain are hallmark symptoms.
• Non-specific symptoms : Headache, cough, sweating, myalgia, arthralgia, fatigue.
• Paralytic ileus is the MC complication of typhoid.
• Intestinal hemorrhage (2nd MC) may be the leading symptom.
Ist week
2nd week
3rd week
4th week