A 7-year-old child with enteric fever develops sudden severe abdominal pain, rebound tenderness, and rigidity on day 18 of illness. Abdominal X-ray shows free gas under the diaphragm. Which site is most commonly perforated in typhoid enteric fever?

• A Jejunum
• B Sigmoid colon
• C Caecum
• D Ileum ✓

Explanation

Intestinal perforation is a complication of enteric fever, typically occurring in the third week of illness. The terminal ileum is the most commonly perforated site because Peyer's patches are most numerous and prominent in the distal ileum, where Salmonella typhi causes hyperplasia, necrosis, and ulceration. Free gas under the diaphragm confirms perforation.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.