Spontaneous enterocutaneous fistula--A rare presentation of enteric fever.
BACKGROUND
Enterocutaneous fistulae (ECFs) after typhoid perforation have been previously recorded postoperatively due to repair leak or new perforation. Spontaneous ECF formation due to primary intra-abdominal pathologic processes has been attributed to infectious diseases such as tuberculosis and Crohn's disease. A review of the literature has shown no previous report of spontaneous ECF caused primarily by salmonella typhi infection.


OBJECTIVE
To report a case of spontaneous ECF due to salmonella typhi infection.


METHODS
An eight-year-old female presented with high fever and weight loss of two weeks' duration and a one-week history of a foul-smelling umbilical discharge. She was ill looking, wasted, with evidence of peritonitis. An emergency exploratory laparotomy revealed multiple perforations at the antimesenteric border of the ileocecal valve. With intestinal resection and anastomosis and the use of broad spectrum antibiotics, her clinical state improved. Tissue biopsy showed hemorrhagic necrosis with infiltration by mononuclear inflammatory cells.


CONCLUSIONS
ECF is a rare complication of enteric fever, Enteric fever should therefore be considered in ill children presenting with ECF in the absence of a history of previous surgery, or blunt or penetrating trauma.
Otaigbe
Barbara Edewele
BE
Department of Pediatric Cardiology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria. barbiejoe64@yahoo.com
Anochie
Ifeoma Comfort
IC
Gbobo
Ifefoma
I
D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D007080:Ileocecal Valve; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D007416:Intestinal Perforation / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D007813:Laparotomy; D012422:Rupture, Spontaneous; D014435:Typhoid Fever / Q000150:complications* / Q000175:diagnosis