Comparative Analysis of Terminal Ileum Perforation Caused By Typhoid Fever And Intestinal Tuberculosis In The Tribal Population of Western Maharashtra In A Tertiary Care Hospital

Background: Terminal ileum perforation is a serious complication commonly caused by typhoid fever and intestinal tuberculosis, both of which are prevalent in underserved populations. Objective: This study aims to compare the clinical presentation, diagnostic challenges, surgical management, and postoperative outcomes of terminal ileum perforation caused by these two conditions in the tribal population of Western Maharashtra. Methods: This retrospective observational study was conducted at tertiary care hospital from February 2023 to June 2025 A total of 56 patients diagnosed with terminal ileum perforation, 28 due to typhoid fever and 28 due to intestinal tuberculosis, were included. Data were collected from medical records, including demographic details, clinical presentation, laboratory findings, surgical interventions, postoperative outcomes, and follow-up results. Results: Patients in both groups presented with similar symptoms, including abdominal pain, fever, and vomiting. However, fever was more common in the typhoid fever group (100%), while abdominal pain was more prominent in the intestinal tuberculosis group (96.4%). Typhoid fever was confirmed through blood cultures, while intestinal tuberculosis was diagnosed based on clinical, histopathological, and PCR tests. The need for bowel resection was significantly higher in the intestinal tuberculosis group (60.7% vs. 0%), and the length of hospital stay was longer in the intestinal tuberculosis group (14.2 ± 4.6 days vs. 10.6 ± 3.2 days). Mortality was observed in 3.5% of the intestinal tuberculosis group, while no mortality occurred in the typhoid fever group. Conclusions: While both typhoid fever and intestinal tuberculosis can lead to terminal ileum perforations, the latter is associated with more severe outcomes, including the need for bowel resection, prolonged hospital stays, and higher mortality rates. Early diagnosis and timely surgical intervention are crucial in improving outcomes, particularly for intestinal tuberculosis