Dry Gangrene in Children with Typhoid Intestinal Perforation: A Report of Two Cases


Lofty-John C. Anyanwu, Aminu M. Mohammad, Lawal B. Abdullahi, Mustapha U. Ibrahim, Aliyu U. Farinyaro, Mohammed S. Aliyu, and Stephen K. Obaro.


Intestinal perforation is a life-threatening complication of typhoid fever commonly seen in developing countries, but extraintestinal complications are infrequently reported. We report herein two cases of gangrene seen in children managed for typhoid intestinal perforation, highlighting the challenges faced in their management.
Most reports show that Symmetrical peripheral gangrene (SPG) carries a high mortality and morbidity rate, as no particular therapeutic option has been shown to consistently prevent the progression of the gangrene. Early identification of the disease and promptly addressing the known precipitating factors may improve outcome. We believe that endotoxemia and peripheral vascular collapse resulting from shock may have been responsible for the gangrene in our patients. Peripheral gangrene complicating typhoid septicemia is a rare but often deadly complication of the disease. A high index of suspicion is recommended in the detection of this complication in children with typhoid fever.


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