Copyright
©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2017; 23(11): 1925-1931
Published online Mar 21, 2017. doi: 10.3748/wjg.v23.i11.1925
Published online Mar 21, 2017. doi: 10.3748/wjg.v23.i11.1925
Typhoid intestinal perforation in developing countries: Still unavoidable deaths?
Sandro Contini, Former Professor of Surgery, Department of Surgical Sciences, University of Parma, 43123 Parma, Italy
Author contributions: Contini S contributed all to this paper.
Conflict-of-interest statement: Contini S declares no conflict of interest related to this publication.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sandro Contini, MD, Professor, Department of Surgical Sciences, University of Parma, Strada S. Eurosia 45/B, 43123 Parma, Italy. sandrocontini46@gmail.com
Telephone: +39-348-5656989 Fax: +39-521-251019
Received: January 11, 2017
Peer-review started: January 12, 2017
First decision: February 9, 2017
Revised: February 20, 2017
Accepted: March 6, 2017
Article in press: March 6, 2017
Published online: March 21, 2017
Peer-review started: January 12, 2017
First decision: February 9, 2017
Revised: February 20, 2017
Accepted: March 6, 2017
Article in press: March 6, 2017
Published online: March 21, 2017
Core Tip
Core tip: Typhoid perforation in low-middle-income countries has still a disappointing outcome, related to surgical and not surgical constraints: (1) safe water and sanitation are lacking in high risk settings like slums or overcrowded areas; (2) currently available diagnostic facilities have inherent limitations; (3) multiple drugs resistant bacteria are an increasingly threatening problem; (4) vaccination programs in some high risk regions, like sub-Saharan Africa, have not yet been carried out; (5) surgery is often delayed; (6) in peripheral facilities postoperative intensive care is problematic and often unsuitable; and (7) surgical standards and guidelines are not available due to the lack of sound prospective studies.