Typhoid intestinal perforation in pregnancy

Abstract

Typhoid intestinal perforation is a serious surgical complication of typhoid fever due to its associated high morbidity and mortality. Its occurrence in pregnancy is extremely rare and poses great challenges in its management.
We report the case of a 31-year-old pregnant woman at 15 weeks of gestation who presented with generalized peritonitis from typhoid intestinal perforation. She had laparotomy with simple closure of an ileal perforation. Prophylactic sublingual tocolytics was commenced in the early postoperative period. However, she lost the pregnancy following a miscarriage 3 weeks after discharge from the hospital.
Typhoid intestinal perforation in pregnancy is uncommon and characterized by diagnostic and treatment challenges. It is associated with a high maternal and foetal morbidity and mortality, thus, requiring a high index of suspicion, prompt intervention, an inter-professional team approach, and close postoperative monitoring to achieve a favourable outcome.