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Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen

Enteric fever is a common infectious disease, especially in countries with poor sanitation and in the tropics. It is caused mainly by Salmonella typhi and accounts for nearly 27 million cases worldwide and 200,000 deaths annually. Enteric fever involves the reticuloendothelial system such as bone ma...

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Autores principales: Malik, Mustafa N, Mahmood, Tayyab, Tameez Ud Din, Asim, Aslam, Shehroz, Imtiaz, Maria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590853/
https://www.ncbi.nlm.nih.gov/pubmed/31259125
http://dx.doi.org/10.7759/cureus.4516
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author Malik, Mustafa N
Mahmood, Tayyab
Tameez Ud Din, Asim
Aslam, Shehroz
Imtiaz, Maria
author_facet Malik, Mustafa N
Mahmood, Tayyab
Tameez Ud Din, Asim
Aslam, Shehroz
Imtiaz, Maria
author_sort Malik, Mustafa N
collection PubMed
description Enteric fever is a common infectious disease, especially in countries with poor sanitation and in the tropics. It is caused mainly by Salmonella typhi and accounts for nearly 27 million cases worldwide and 200,000 deaths annually. Enteric fever involves the reticuloendothelial system such as bone marrow, spleen, and liver. As it mostly involves the Peyer’s patches of the terminal ileum, enteric perforation occurs commonly. However, gallbladder perforation can also occur, though not very often. Ultrasound as well as computerized tomography (CT) abdomen and pelvis lack specificity for detecting gallbladder perforations in enteric fever. Diagnosis is usually confirmed intraoperatively when the gallbladder is visualized and perforation is seen. Gallbladder perforation is usually seen in acute cholecystitis when the gallbladder becomes necrotic and gangrenous. In acalculous cholecystitis, perforation is rare. Enteric fever is one of the rarest causes of acalculous cholecystitis, leading to perforation. Here, we present the case of a 20-year-old man who presented with fever for 10 days along with loose stools, vomiting, and acute abdomen. Labs showed leukopenia, positive Typhidot test but X-ray erect abdomen and ultrasound abdomen and pelvis were nonspecific. Only after resuscitation and exploration of the abdomen was it found that the gallbladder had multiple perforations. The patient was improved after eight days of postoperative intravenous antibiotics. This is a unique and rare presentation of such a common infectious disease.
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spelling pubmed-65908532019-06-29 Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen Malik, Mustafa N Mahmood, Tayyab Tameez Ud Din, Asim Aslam, Shehroz Imtiaz, Maria Cureus Internal Medicine Enteric fever is a common infectious disease, especially in countries with poor sanitation and in the tropics. It is caused mainly by Salmonella typhi and accounts for nearly 27 million cases worldwide and 200,000 deaths annually. Enteric fever involves the reticuloendothelial system such as bone marrow, spleen, and liver. As it mostly involves the Peyer’s patches of the terminal ileum, enteric perforation occurs commonly. However, gallbladder perforation can also occur, though not very often. Ultrasound as well as computerized tomography (CT) abdomen and pelvis lack specificity for detecting gallbladder perforations in enteric fever. Diagnosis is usually confirmed intraoperatively when the gallbladder is visualized and perforation is seen. Gallbladder perforation is usually seen in acute cholecystitis when the gallbladder becomes necrotic and gangrenous. In acalculous cholecystitis, perforation is rare. Enteric fever is one of the rarest causes of acalculous cholecystitis, leading to perforation. Here, we present the case of a 20-year-old man who presented with fever for 10 days along with loose stools, vomiting, and acute abdomen. Labs showed leukopenia, positive Typhidot test but X-ray erect abdomen and ultrasound abdomen and pelvis were nonspecific. Only after resuscitation and exploration of the abdomen was it found that the gallbladder had multiple perforations. The patient was improved after eight days of postoperative intravenous antibiotics. This is a unique and rare presentation of such a common infectious disease. Cureus 2019-04-22 /pmc/articles/PMC6590853/ /pubmed/31259125 http://dx.doi.org/10.7759/cureus.4516 Text en Copyright © 2019, Malik et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Malik, Mustafa N
Mahmood, Tayyab
Tameez Ud Din, Asim
Aslam, Shehroz
Imtiaz, Maria
Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen
title Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen
title_full Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen
title_fullStr Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen
title_full_unstemmed Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen
title_short Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen
title_sort gallbladder perforation secondary to enteric fever: an interesting case of acute abdomen
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590853/
https://www.ncbi.nlm.nih.gov/pubmed/31259125
http://dx.doi.org/10.7759/cureus.4516
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