بررسی آماری پریتونیت تیفوئیدی در بخش جراحی بیمارستان امام خمینی تبریز از سال ۱۳66-۱۳71

ABSTRACT: In this article we have studied 175 peritonitis:12 of them have occured because of testine perforation in persistent typhoid. Seven of the patients were female (mean 58%) and five were male (42%). Their average age was 22. Clinical features of this group of patients were high fever(above 39“), abdominal pain vomitting ,diarrhea ,constipation ,dilation of the abdomen ,rigidity and reboundedness. Laboratory examinations consist of: anemia positive vidal test (83%) , positive blood and stool culture (8%) .Radiographic examination was pneumoperitoneum in 42% of the patients. Laparotomy was done on all of the patients. 75% had only one perforation that was primarily repaired. And in a few cases(17%) small intestine was resected and primarily anastomosed because of several perforations. Effective antibiotic in all operated patients was choloramephnicol with Gentamicin or choloramphenicol with penicilin V. Fortunately 42% of the patients were discharged without complications. And postoperative complications were present in 58% of patients and this complications were regularly: interabdominal abscess(17%)dehiscence(8%),recurrent perforation of intestine (8%),leak of anastomosis(8%),obstruction (8%), and respiratory complications such as:Atelectasis ARDS(8%). Total mortality was 25% (mean only 3 of them died.2 cases were because of Septicemia and the other one was due to ARDS.The increasing reasons of mortality were :Delay in operation because of misdiagnosis ,the degree of contamination of the peritoneum the number of perforations ,dysentry,leukopenia during peritonitis and unconsciousness. The key of recovery after operation is:quick diagnosis and operation ,correct post oprative care of the patient ,prevention of typhoid following hygienic rules.