A 38-year-old man with a history of fever associated with abdominal pain of 3-week duration presents now with a sudden onset of abdominal pain and copious vomiting. Plain abdominal x-rays reveal air under a diaphragm. A CT scan shows mesenteric lymphadenopathy and splenomegaly is found. Laparotomy is performed and 3 feet of ileum resected. The luminal aspect of the resected bowel shows marked ulceration of Peyer's patches. What is the most likely diagnosis?
Typhoid fever typically presents with initial symptoms. Small intestine complications are related to involvement of Peyer's patches of the small intestine, which result in bleeding and/or perforation in the second and third week after symptoms are noted.
Typhoid enteritis
Tuberculosis enteritis
Crohn's disease
Primary peritonitis
Small & Large Intestine