مقالات پذیرفته شده در نهمین کنگره بین المللی زیست پزشکی
Caecal and Colon Rupture Due to Thyphoid Fever in A 22 Years Old Male, A Rare Complication: A Case Report
Caecal and Colon Rupture Due to Thyphoid Fever in A 22 Years Old Male, A Rare Complication: A Case Report
Ahmad Reza Shahraki,1,*Elahe Shahraki,2Elham Shahraki,3
1. General Surgeon ,Assistant professor, Department of General Surgery ,Zahedan Medical Faculty , Zahedan University of Medical Sciences and Health Services, Zahedan, Iran. 2. Dentist, Periodontology resident, Dental Faculty, Tehran University of medical Sciences, Tehran, I.R. Iran.
Introduction: Typhoid fever is an acute infection caused by Salmonella typhi, especially when it is waterborne or foodborne. The most common laboratory diagnosis of
typhoid/enteric fever comprises clinical specimens such as blood, stool, urine, and bone marrow; the polymerase chain reaction; and the Widal test. The
primary clinical symptoms of typhoid/enteric fever are high-grade fever, chills, stomach discomfort, tachycardia, generalized body pain, back pain, and
headaches. Intestinal perforation is one of the most dangerous complications of typhoid fever and demands urgent hospitalization, diagnosis, and surgical
management to reduce morbidity and prevent mortality. The mechanism whereby infection results in perforation is due to bacterial attachment and invasion,
causing subsequent hyperplasia and necrosis of the immune sentinel microfold cells, anatomically visible in Peyer’s patches. The usual site of perforation is
at the anti-mesenteric border of the ileum; however, other sites can also be affected such as the cecum, jejunum,colon. Ciprofloxacillin is a fluoroquinolone
antibiotic that is the preferred treatment for typhoid fever.
Methods: Our case was a 22 years old male with fever for 10 days and referred to surgery part with acute abdominal presentation and positive Widal test.In laparotomy
Caecal and Colon rupture was found and right hemicolectomy did for him and we did treatment of thyphoid fever and we save his life.
Results: A right hemicolectomy is recommended for caecal typhoid perforations especially when it is associated with extensive inflammation, necrosis and peritoneal
soilage. This case report was submitted in accordance with the SCARE criteria7.
Conclusion: Typhoid fever is an infection of the intestinal tract and bloodstream
caused by the bacteria S. typhi. Typhoid fever has been associated
with travel history in underdeveloped countries because of
unsafe drinking water sources and eating contaminated food
[1]. The presence of H and O serum agglutinins in the patient’s
serum was investigated by a Widal test. In underdeveloped
countries, the Widal test is frequently performed because it is
cheaper, easier to perform, and does not require microbiology
experts. Ciprofloxacillin is a fluoroquinolone antibiotic that
is the preferred treatment for typhoid fever [1]. Typhi is the
agent of typhoid/enteric fever, which is primarily a bloodstream
infection. Typhoid diseases have been linked to travel histories
in developing nations owing to tainted food and contaminated water supplies. The usual site of perforation is at the antimesenteric
border of the ileum; however, other sites can also
be affected such as the cecum, jejunum, colon [14]. Caecal and
colonic perforations have been documented as rare, occurring in
0.05% to 3% of typhoid intestinal perforations [15,16]. A right
hemicolectomy is recommended for caecal typhoid perforations
especially when it is associated with extensive inflammation,
necrosis and peritoneal soilage