A 30-year-old man presents to the emergency department with severe abdominal pain, fever, and signs of peritonitis. He has a history of recent typhoid fever. The surgical team suspects a gastrointestinal perforation.
Typhoid perforations most commonly occur in:
A. Appendix
B. Rectum
C. Jejunum
D. Caecum
E. Ileum
Answer:
The Correct Answer is: E. Ileum
Explanation:
Ileum (E):
– Typhoid fever, caused by the bacterium *Salmonella typhi*, can lead to ulceration of the Peyer’s patches in the terminal ileum. This ulceration can progress to perforation, which is a serious complication of typhoid fever.
– The ileum is the most common site for typhoid perforations due to the high concentration of lymphoid tissue (Peyer’s patches) in this region, which is affected by the infection.
Explanation of Incorrect Options:
Appendix (A):
– While the appendix can be involved in various infections and conditions, it is not the common site for typhoid perforations.
Rectum (B):
– The rectum is not typically involved in typhoid perforations. Typhoid fever primarily affects the small intestine, particularly the ileum.
Jejunum (C):
– Although the jejunum is part of the small intestine, it is less commonly involved in typhoid perforations compared to the ileum.
Caecum (D):
– The caecum can be affected by typhoid fever, but it is not the most common site for perforations. The ileum remains the most frequent site.
In conclusion, typhoid perforations most commonly occur in the ileum, making option E the correct answer.