Typhoid perforation occurs during

• Enteric fever is a potentially life - threatening systemic disease characterized by fever and abdominal pain. • It is caused by Salmonella typhi or paratyphi. • Typhoid is the MC cause of ileal perforation in tropical countries (India). Pathology : • Ulceration and necrosis of ileocecal Peyer’s patches. • The ulcer is parallel to the long axis of the gut and is usually situated in the lower ileum (longitudinal ulcers). • Perforation of a typhoid ulcer usually occurs during the third week and is occasionally the first sign of the disease. Clinical Features : • Fever and abdominal pain are hallmark symptoms. • Non-specific symptoms : Headache, cough, sweating, myalgia, arthralgia, fatigue. • Paralytic ileus is the MC complication of typhoid. • Intestinal hemorrhage (2nd MC) may be the leading symptom.