Surgical complications of enteric fever in children

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.