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
- 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 :
In familial adenomatous polyposis, which of the following all are true ?
1. Presence of $>100$ colorectal polyps
2. Positive family history
3. Autosomal Recessive inheritance
4. Genetic mutation on Chromo- some 5
Select the correct answer using the code given below :
- Among the extra intestinal manifesta- tions of Crohn's disease which one of the following is related to the disease activity?
Which of the following statements with regard to Enteric perforation are correct?
1. Salmonella typhi is the causative organism for Enteric fever
2. Enteric perforation characteristi- cally occurs during third week of illness
3. Typhoid ulcers are placed trans- versely to the long axis of the gut
4. Terminal ileum is the most common site for enteric perfora- tion
Select the correct answer using the code given below :
