ArticlePakistan journal of medical sciences2025
Frequency of typhoid-related intestinal perforation with atypical clinical presentation at Tertiary Care Hospital in Pakistan.
Article in Pakistan journal of medical sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To determine the frequency of cases with atypical clinical history diagnosed as typhoid-related intestinal perforation (TIP) in a tertiary care hospital. Methodology: A Cross sectional study was conducted in department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, from 20 Results: Median age was 23 (18, 35) years with 82.7 % male predominance. Out of ninety-eight cases, 96.94% (95) had at least one atypical clinical feature while 23.49% (23) had all three atypical features at presentation. About 75.5% (74) of the cases had atypical duration of illness (≤14 days or >21 days). 76.53% (70) had atypical fever pattern (other than continuous step ladder). 5.1% (5) were afebrile, also considered as atypical. 41.84% (41) had atypical bowel habits (normal). Most common time of presentation was week-one 38.8% (38), followed by week-three, week-two and beyond week-three. The most common fever pattern was intermittent 66.3%, followed by continuous, remittent and relapsing. Constipation was more common 58.16% (57) than diarrhea 41.84% (41). Conclusion: Majority of patients with TIP had short duration of illness and intermittent pattern of fever, which were prone to be misdiagnosed due to their atypical presentation. Such cases must come into consideration for timely and adequate management of the disease.
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