Enteric Fever Complications Explained
The patient presents with symptoms suggestive of a serious intra-abdominal event, including sudden generalized abdominal pain, distension, nausea, vomiting, and signs of peritonitis (generalized tenderness, rebound tenderness, board-like rigidity). Vital signs show tachycardia (PR = 110/min) and hypotension (BP = 100/60 mm Hg), indicating potential sepsis or shock.
Analyzing Potential Complications
While the classic signs of peritonitis strongly suggest bowel perforation, a known severe complication of enteric fever, other complications can occur:
- Small bowel enteritis: Typically causes diarrhea, not constipation and rigidity.
- Small bowel perforation: Presents with signs of peritonitis as seen here, but is not the designated answer.
- Small bowel obstruction: Can cause pain, distension, and vomiting, but usually lacks the sudden onset rigidity characteristic of perforation.
- Cholecystitis: Inflammation of the gallbladder. While less commonly suggested by these specific peritonitic signs, enteric fever can lead to gallbladder complications (typhoid cholecystitis). This can sometimes present with severe abdominal pain, potentially mimicking other acute abdominal conditions, especially in the context of systemic illness.
Identifying Cholecystitis as the Complication
Given that Cholecystitis is the provided answer, the reasoning focuses on the possibility of secondary gallbladder involvement during enteric fever. The systemic effects of enteric fever can potentially affect the gallbladder, leading to inflammation. Factors contributing to this diagnosis could include:
- Enteric fever caused by Salmonella Typhi, which resides in the gallbladder.
- Systemic stress response potentially exacerbating gallbladder issues.
- Atypical presentation of abdominal pain.
Therefore, considering the options and the provided correct answer, Cholecystitis is identified as the most likely complication in this specific scenario.
Important Questions from Intestines
- A 22-year female has presented with a history of malaise, cough, alternating constipation and diarrhoea with intermittent abdominal pain for last 6 months. She also complains of abdominal distension for last 2 days. On examination her abdomen has a doughy feel along with an ill defined mass over the right lower quadrant. She is most likely suffering from:
- Gentleman of 56 years underwent laparoscopic left hemicolectomy for diagnosed left colonic carcinoma. Histopathology revealed the tumour to be invading submucosa and muscularis propria. Among the 16 regional lymph nodes harvested, 2 were positive for malignant deposits.
His staging as per AJCC will be: - A 40 year old female patient presents with colicky abdominal pain associated with episodes of mild diarrhoea for last 6 months accompanied with intermittent fever and weight loss. There are multiple discharging sinuses on perineal examination. The most likely clinical diagnosis in this patient is:
- An eight month old male child is brought to the emergency with recurrent episodes of screaming and drawing up of legs. The child appears to be listless in between the attacks. Local examination of abdomen reveals feeling of emptiness in the right iliac fossa and blood stained mucus is found on the finger on per rectal examination. The most probable clinical diagnosis in this child is
- Which of the following statements regarding Ogilvie's syndrome are correct?
1. It presents as acute large bowel mechanical obstruction
2. Marked caecal dilatation is a common feature on X-ray abdo- men
3. Caecal perforation is a well recog- nized complication of this condi- tion
4. Intravenous Neostigmine is used for the treatment of this condition
Select the correct answer using the code given below :
