Varanasi, India

Author Affiliations: Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, U.P. India (Pandey A, Gangopadhyay AN, Upadhyaya VD)

Corresponding Author: AN Gangopadhyay, Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, U.P. India (Tel: +91 542 2309527; Email: gangulybhu@rediffmail.com)

Background: Typhoid fever is a severe infective disease endemic in the areas where sanitation is poor. Its serious complication is bowel perforation with terminal ileum as the commonest perforation site. We report a case of an extremely unusual site of perforation in sigmoid colon due to typhoid fever.

Methods: An 18-month-old boy presented with no passage of flatus and feces along with guarding and rigidity. Exploratory laparotomy revealed sigmoid colon perforation and Widal test was strongly positive for typhoid fever. Sigmoid loop colostomy was performed on the patient.

Results: Postoperative period was uneventful. Colostomy started functioning on the 4th post-operative day. There was superficial wound dehiscence. The patient was given oral food intake on the 7th post-operative day. He was discharged from the hospital in satisfactory conditions on the 10th day after operation.

Conclusions: While tackling a case of enteric perforation suspected with typhoid fever, one should keep in mind the extremely rare site of sigmoid colon perforation.

Key words: intestinal perforation; sigmoid colon; typhoid fever

                 World J Pediatr 2008;4(4):305-307