Outcome of Laparotomy for Typhoid Intestinal Perforation at Benue State University Teaching Hospital

Typhoid intestinal perforation remains a life-threatening surgical emergency in Nigeria, most commonly affecting children and young adults in communities with poor water sanitation. This study evaluates the surgical management and postoperative outcomes of typhoid intestinal perforation at Benue State University Teaching Hospital (BSUTH), Makurdi, Benue State, North Central Nigeria, from 2019 to 2023. A retrospective review of 95 operative case records was conducted. Data collected included patient demographics, duration of illness before surgery, number and location of perforations, type of surgical repair (simple closure versus resection and anastomosis), postoperative complications, and mortality. Descriptive and inferential statistics were applied. The mean duration of illness prior to surgery was 8.4 days. Multiple perforations were found in 32% of cases, and terminal ileum involvement was universal. Simple closure was performed in 67% of cases. Postoperative complications included wound infection (44%), fecal fistula (11%), and chest infection (9%). Mortality was 14%, with delayed presentation and multiple perforations as the strongest predictors. The study recommends strengthening water and sanitation infrastructure in Benue State communities, ensuring typhoid vaccination coverage, and improving emergency surgical capacity in North Central Nigeria to reduce preventable typhoid perforation mortality. Keywords: typhoid perforation, laparotomy, intestinal perforation, Benue, postoperative