Life-threatening arterial bleeding in hemorrhagic-necrotizing salmonella ileitis

A 23-year-old man in otherwise good health had diarrhoea for two days during a holiday on Maldives. Two months later he suddenly collapsed and had to be admitted to hospital. Haemoglobin concentration was found to be 76 g/l, with a haematocrit of 0.22, WBC count of 17,800/microliters and platelets o...

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Bibliographic Details
Published inDeutsche medizinische Wochenschrift Vol. 118; no. 26; p. 971
Main Authors Jaspersen, D, Rumpf, K D, Bässler, R, Bonzel, T, Hammar, C H
Format Journal Article
LanguageGerman
Published Germany 02.07.1993
Subjects
Adult
Anastomosis, Surgical
Cecum - surgery
Ciprofloxacin - therapeutic use
Colon - surgery
Gastrointestinal Hemorrhage - diagnosis
Gastrointestinal Hemorrhage - etiology
Gastrointestinal Hemorrhage - surgery
Humans
Ileitis - diagnosis
Ileitis - etiology
Ileitis - surgery
Ileum - pathology
Ileum - surgery
Male
Necrosis
Salmonella - isolation & purification
Salmonella Food Poisoning - complications
Salmonella Food Poisoning - diagnosis
Salmonella Food Poisoning - drug therapy
Ulcer
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Summary:A 23-year-old man in otherwise good health had diarrhoea for two days during a holiday on Maldives. Two months later he suddenly collapsed and had to be admitted to hospital. Haemoglobin concentration was found to be 76 g/l, with a haematocrit of 0.22, WBC count of 17,800/microliters and platelets of 22%. Massive passage of bright red blood in the stools (none previously) could not be explained by abdominal sonography, oesophagogastroduodenoscopy, coloscopy, technetium scintigraphy or angiography of the superior mesenteric artery. Exploratory laparotomy revealed severe inflammatory changes in the terminal ileum with enlargement of the regional lymph-nodes and spurting bleeding from a branch of the ileocolic artery. Histological examination showed focal necrotizing, ulcerative and haemorrhagic ileitis. After ileocaecal resection and end-to-end anastomosis to the ascending colon the patient quickly recovered. Salmonella Livingstone was isolated from the stool and the infection was treated with ciprofloxacin, 200 mg twice daily intravenously for 5 days. Subsequent stool samples were negative but follow-up continues.
ISSN:0012-0472