Right Hemicolectomy for Intestinal Obstruction Due to Yersinia pseudotuberculosis: A Histopathological Surprise

A 56-year-old man was diagnosed to be having enteric fever elsewhere and put on antibiotics. Despite therapy over 3 months, this patient had recurrent bouts of fever with chills, tiredness, and lower abdominal pain, distension, and vomiting with which he was admitted to our hospital. CT abdomen and pelvis showed significant wall thickening in the cecum and terminal ileum, with marked luminal narrowing and marked dilatation of proximal small bowel loops. Clinically a diagnosis of intestinal obstruction was made and the patient underwent exploratory laparotomy and right hemicolectomy. Histopathological examination showed necrotizing enteritis with necrotizing mesenteric lymphadenitis consistent with Yersinia pseudotuberculosis. We report a rare and possibly the first case of intestinal obstruction due to Yersinia infection, requiring right hemicolectomy.