Srinivasa K G, Vidhya J V, Manohar T M, Naik M
St. Teresa Hospital, Bangalore, Karnataka India.
Indian J Surg. 2013 Jun;75(Suppl 1):214-6. doi: 10.1007/s12262-012-0580-y. Epub 2012 Jul 4.
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.
一名56岁男性在其他地方被诊断为患肠热病，并接受了抗生素治疗。尽管经过3个月的治疗，该患者仍反复出现发热、寒战、疲倦以及下腹部疼痛、腹胀和呕吐症状，遂入住我院。腹部和盆腔CT显示盲肠和回肠末端肠壁明显增厚，管腔显著狭窄，近端小肠袢明显扩张。临床上诊断为肠梗阻，患者接受了剖腹探查术和右半结肠切除术。组织病理学检查显示为坏死性肠炎伴坏死性肠系膜淋巴结炎，符合假结核耶尔森菌感染。我们报告了一例罕见的、可能也是首例因耶尔森菌感染导致肠梗阻并需要进行右半结肠切除术的病例。
