Related Experiment Videos
Acute abdomen caused by Salmonella typhimurium infection in children
1Department of Pediatric Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
Insights
Salmonella typhimurium infections can cause acute abdominal issues, sometimes requiring surgery. Early diagnosis is crucial to avoid unnecessary operations for conditions mimicking appendicitis or intestinal obstruction.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Gastroenterology
Background:
- Salmonella spp. infections can present as acute abdominal conditions, necessitating emergency surgery.
- Complications include intestinal perforation, gallbladder involvement, salpingitis, and peritonitis.
- Mesenteric lymphadenitis from Salmonella typhimurium can mimic appendicitis, complicating diagnosis in children.
Observation:
- Two pediatric cases highlight surgical challenges posed by Salmonella infections.
- One patient presented with appendicitis-like symptoms due to inflamed mesenteric lymph nodes.
- The other experienced intestinal obstruction from dense mesenteric adhesions.
Findings:
- Both patients showed elevated "B and O agglutinating" (BO) antibody titers to 1:640, indicative of Salmonella typhimurium infection.
- Inflamed mesenteric lymph nodes mimicked appendicitis in one case.
- Ileal adhesions caused complete intestinal obstruction in the second case.
Implications:
- Salmonella infections can lead to rare but severe surgical emergencies in children.
- Accurate diagnosis is vital to prevent unnecessary surgical interventions.
- Understanding these presentations improves management of pediatric Salmonella cases.
Abstract:
Salmonella spp. infections can be particularly challenging when they manifest as acute abdominal problems and lead to emergency surgery. Examples of such serious conditions are Salmonella-related intestinal perforation, gallbladder involvement, salpingitis, and peritonitis. Mesenteric lymphadenitis associated with Salmonella typhimurium mimics acute appendicitis and can make it difficult to establish a timely and definitive diagnosis in young patients who present with right lower abdominal pain. Paralytic ileus is a fairly common manifestation of Salmonella infection at all ages, but complete intestinal obstruction requiring surgical intervention is very rare. Because of the nature of the diagnostic process, a significant number of patients with Salmonella infection present with acute abdomen and undergo needless operations. This report describes the cases of 2 pediatric patients who underwent surgery to address persistent pain in the right lower abdominal quadrant and complete intestinal obstruction, respectively. The first patient had inflamed mesenteric lymph nodes that caused appendicitislike symptoms, and the second had dense adhesions between the mesentery and the terminal segments of the ileum that led to intestinal blockage. Serology results showed that both patients' titers for BO ("B and O agglutinating [BO]") antibodies rose to 1:640 in the week after their admission to hospital, a pattern and level that is indicative of S typhimurium infection. J Pediatr Surg 36:1849-1852.