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[Phlegmonous enteritis--a rare cause of acute abdomen]
1Patologisk-anatomisk institut og kirurgisk gastroenterologisk afdeling, Arhus Kommunehospital.
Abstract:
A 73 year old woman presenting with an acute abdomen was diagnosed as having phlegmonous enteritis after microscopic examination revealed the characteristic finding of a diffuse suppurative inflammation limited to the submucosa in the resected ileal segment. Culture of Klebsiella pneumoniae, and the microscopic demonstration of gram positive cocci and gram negative rods confirmed the bacterial etiology of this disease. There was no evidence of mucosal injury in this patient, but the possible role of ischemia secondary to atherosclerotic vascular disease cannot be assessed. Because of the associated high morbidity and mortality, phlegmonous enteritis should be considered in the differential diagnosis of acute abdomen.
Insights
Phlegmonous enteritis, a rare cause of acute abdomen, involves diffuse submucosal inflammation. This case highlights Klebsiella pneumoniae as a potential bacterial cause, emphasizing its importance in differential diagnoses.
Area of Science:
- Gastroenterology
- Pathology
- Infectious Diseases
Background:
- Acute abdomen is a common clinical presentation requiring prompt diagnosis.
- Phlegmonous enteritis is a rare but serious condition characterized by diffuse inflammation of the intestinal wall.
- Bacterial infections are implicated in the etiology of various gastrointestinal disorders.
Observation:
- A 73-year-old woman presented with acute abdomen.
- Microscopic examination of a resected ileal segment revealed diffuse suppurative inflammation limited to the submucosa.
- No mucosal injury was evident, but potential ischemic factors were considered.
Findings:
- The patient was diagnosed with phlegmonous enteritis.
- Klebsiella pneumoniae was identified through bacterial culture.
- Microscopic findings confirmed a mixed bacterial etiology with gram-positive cocci and gram-negative rods.
Implications:
- Phlegmonous enteritis, despite its rarity, must be considered in the differential diagnosis of acute abdomen.
- Prompt recognition and management are crucial due to high associated morbidity and mortality.
- This case underscores the role of bacterial pathogens, such as Klebsiella pneumoniae, in causing severe intestinal inflammation.