Abstract
BACKGROUND: Enterocutaneous fistulae (ECFs) after typhoid perforation have been previously recorded postoperatively due to repair leak or new perforation. Spontaneous ECF formation due to primary intra-abdominal pathologic processes has been attributed to infectious diseases such as tuberculosis and Crohn's disease. A review of the literature has shown no previous report of spontaneous ECF caused primarily by salmonella typhi infection. OBJECTIVE: To report a case of spontaneous ECF due to salmonella typhi infection. CASE REPORT: An eight-year-old female presented with high fever and weight loss of two weeks' duration and a one-week history of a foul-smelling umbilical discharge. She was ill looking, wasted, with evidence of peritonitis. An emergency exploratory laparotomy revealed multiple perforations at the antimesenteric border of the ileocecal valve. With intestinal resection and anastomosis and the use of broad spectrum antibiotics, her clinical state improved. Tissue biopsy showed hemorrhagic necrosis with infiltration by mononuclear inflammatory cells. CONCLUSION: ECF is a rare complication of enteric fever, Enteric fever should therefore be considered in ill children presenting with ECF in the absence of a history of previous surgery, or blunt or penetrating trauma.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Habib A. G. A clinical audit of presentation and outcome of Salmonella septicaemia. Ann Acad Med Singapore. 2004 Nov;33(6):749–753. [PubMed] [Google Scholar]
- Lambotte O., Debord T., Castagné C., Roué R. Unusual presentation of typhoid fever: cutaneous vasculitis, pancreatitis, and splenic abscess. J Infect. 2001 Feb;42(2):161–162. doi: 10.1053/jinf.2000.0783. [DOI] [PubMed] [Google Scholar]
- Lortholary O., Jarrousse B., Attali P., Hoang J. M., Brauner M., Guillevin L. Psoas pyomyositis as a late complication of typhoid fever. Clin Infect Dis. 1995 Oct;21(4):1049–1050. doi: 10.1093/clinids/21.4.1049. [DOI] [PubMed] [Google Scholar]
- Memon Abdul Sattar, Siddiqui Faisal Ghani. Causes and management of postoperative enterocutaneous fistulas. J Coll Physicians Surg Pak. 2004 Jan;14(1):25–28. [PubMed] [Google Scholar]
- Singh N. P., Manchanda Vikas, Gomber Sunil, Kothari Atul, Talwar Vibha. Typhoidal focal suppurative lymphatic abscess. Ann Trop Paediatr. 2002 Jun;22(2):183–186. doi: 10.1179/027249302125000922. [DOI] [PubMed] [Google Scholar]
- Wong S. C. C., Chan A. T. C., Lo E. S. F., Lo Y. M. D. Nuclear beta-catenin expression is rare and its potential association with short survival in colorectal signet-ring cell carcinoma. Appl Immunohistochem Mol Morphol. 2005 Sep;13(3):248–251. doi: 10.1097/01.pai.0000142845.91862.c8. [DOI] [PubMed] [Google Scholar]