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Surgical management of complicated gastrointestinal salmonellosis in children
J C Sheu1, P Y Chang, C C Chen
1Department of Pediatric Surgery, Mackay Memorial Hospital, Taipei, Taiwan, R.O.C.
Insights
Surgical intervention is crucial for pediatric Salmonella infection complications. Early diagnosis and management significantly reduce mortality in young patients.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Gastroenterology
Background:
- Salmonella infections can lead to severe complications in children, necessitating surgical intervention.
- The study focuses on surgical management of Salmonella infection complications in pediatric patients.
Purpose of the Study:
- To review surgical interventions for Salmonella infection complications in children.
- To identify common pathogens, clinical presentations, surgical indications, and outcomes.
Main Methods:
- Retrospective review of 11 pediatric patients undergoing surgery for Salmonella infection complications between 1984 and 1991.
- Analysis of patient demographics, clinical data, surgical procedures, and postoperative outcomes.
Main Results:
- Most patients (64%) were under one year old, with Salmonella paratyphi Gr. B being the most common pathogen.
- Common indications for surgery included pneumoperitoneum (55%) and peritonitis (36%).
- Postoperative complications included wound infection (18%) and adhesion ileus (9%), with no surgical mortality.
Conclusions:
- Prompt diagnosis, resuscitation, and surgical management are essential for preventing mortality in pediatric Salmonella infection complications.
- Ceftriaxone and total parenteral nutrition were key components of postoperative care.
Abstract:
From January 1984 to October 1991, 11 consecutive patients with complication of Salmonella infection received surgical intervention at our hospital. The age at operation ranged from 4 days to 8 years old, with a mean of 1 year and 8 months. Most of them (64%) were under the age of one year. Eight cases were male, 3 cases were female. The most common pathogen was Salmonella paratyphi Gr. B (73%); the most common presenting symptoms and signs were abdominal pain (82%), pyrexia (82%) and muscle guarding (82%). The indications for surgery included pneumoperitoneum (55%), peritonitis (36%) and intestinal obstruction (9%); 6 cases received one stage operation, 5 cases received staged operations (enterostomy). The most commonly involved organ was ileum (54%). Ceftriazone (rocephin) was the drug of choice for the first 2 weeks postoperatively. Total parenteral nutrition (TPN) was used for at least 2 weeks. The postoperative complications included adhesion ileus (9%), high output enterostomy (9%), reperforation (9%), and wound infection (18%); there was no surgical mortality. Prompt diagnosis, early resuscitation and operative management are mandatory to avoid mortality.