Jejunal multiple perforations for combined abdominal typhoid fever and miliary peritoneal tuberculosis

Abstract

Typhoid fever and tuberculosis, considered rare diseases in western countries, is still considered a notable problem of health issue in developing
countries. The gastrointestinal manifestations of typhoid fever are the most common and the typhoid intestinal perforation (TIP) is considered the
most dangerous complication. Abdominal localization of tuberculosis is the 6th most frequent site for extra pulmonary involvement, it can involve any
part of the digestive system, including peritoneum, causing miliary peritoneal tuberculosis (MPT). This is the case report of a 4 years old girl with
multiple jejunal perforations in a setting of contemporary miliary peritoneal tuberculosis and typhoid fever occurred in "Hopital Saint Jean de Dieu"
in Tanguietà, north of Benin. The patient was admitted in the emergency department with an acute abdomen and suspect of intestinal perforation,
in very bad clinical conditions, underwent emergency laparotomy. The finding was a multiple perforations of the jejunum in a setting of combined
abdominal typhoid fever and miliary peritoneal tuberculosis. Typhoid intestinal perforations and peritoneal tuberculosis are a very rare cause of nontraumatic peritonitis in western country, but still common in developing country. Considering the modern migratory flux and the diffusion of volunteer
missions all around the world, the western surgeon should know this pathological entities, and the best treatments available, well known by surgeons
with experience of working in developing countries. The combination of both TIP and MPT in the same patient, is a very rare finding which can
worsen the outcome of the patient itself.