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04-26-2008, 11:44 AM
1- Perforated Typhoid Ulcer:
Site: Terminal ileum.
Shape: Longitudinal with the long axis.
Number: Multiple.
Clinical picture:
Generalized peritonitis due to perforation but with special features:
1- History of prolonged fever ( 2 : 3 weeks).
2- Abdominal rigidity and tenderness are minimal or absent due to marked toxemia.
3- Edematous abdominal wall.
4- Leucocytic count not markedly raised.
5- X-ray shows gas under diaphragm.
Treatment:
* Nasogastric suction. * I.V. fluid.
* Exploration: Do sealing of the perforation with peritoneal lavage & put drains. If there are multiple perforations in short segment do resection and anastomosis after removal of diseased segment.
2- Paralytic ileus.
3- Splenic abscess.
4- Typhoid cholecystitis.
5- Typhoid osteomyelitis.
6- Venous thrombosis.
SOURCE: DR. AYMAN SALEM'S BOOK
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