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2005, Number 1

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Cir Gen 2005; 27 (1)

Toxic megacolon due to salmonellosis. Report of one patient

Noriega MO, Guevara TL, Méndez MM, Falcón ER

Language: Spanish
References: 18
Page: 79-82
PDF size: 82.39 Kb.


ABSTRACT

Objective:To describe a case with toxic megacolon secondary to salmonellosis.
Setting:Third level health care hospital.
Design:Description of one case.
Case description:Woman of 60 years of age, who was admitted with fracture of the pelvis and right hip, in charge of the trauma and orthopedics service. Four days later, she presented tachycardia, important abdominal distension, diminished peristaltic noises, generalized tympanism, without abdominal pain, unable to evacuate or pass gases, respiratory distress, hyperthermia, leukocytosis, anemia, dehydration, mental state alterations, gasometry data were SO2 of 75% and PO2 of 57 mmHg with O2 of 21%. Abdominal X rays revealed colonic dilation. Medical treatment was started, but she deteriorated progressively and was therefore subjected to emergency exploratory laparotomy. Surgical findings were: toxic megacolon and ileitis. Subtotal colectomy was performed with ileostomy and sigmoid closure with Hartman pouch. The histopathological diagnosis was: infectious enterocolitis consisting of salmonellosis with secondary megacolon.
Conclusion:The toxic colon due to salmonella is a very rare entity; in the present report, despite not having isolated the bacterium through culture, the absence of intestinal inflammatory disease antecedents, the clinical manifestations of the patient, the transoperative and laboratory findings helped to integrate the diagnosis of toxic megacolon, and the histopathological findings and the high febrile reactions supported the salmonella etiology.


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