A 25 year old female presents with pyrexia for ten days, develops acute pain in periumbilical region spreading all over the abdomen. What would be the most likely cause?
Enteric Fever Or Typhoid: Enteric fever is a potentially life-threatening systemic disease characterized by fever and abdominal pain. It is caused by Salmonella typhi or paratyphi Typhoid is the MC causeof ileal perforation in tropical countries (India) Pathology Ulceration and necrosis of ileocecal peyer&;s patches The ulcer is parallel to the long axis of the gut and is usually situated in the lower ileum (longitudinal ulcers) Perforation of a typhoid ulcer usually occurs during the third week and is occasionally the first sign of the disease Clinical Features: Fever and abdominal pain are hallmark symptoms Non-specific symptoms: Headache, cough, sweating, myalgia, ahralgia, fatigue Paralytic ileus is the MC complication of typhoid Intestinal hemorrhage(2nd MC) may be the leading symptom Complications of Enteric Fever Paralytic ileus (MC) Intestinal hemorrhage (2nd MC) Perforation Cholecystitis Phlebitis Genitourinary inflammation Ahritis Osteomyelitis Characteristics Signs: Rose spots, splenomegaly, leucopenia with shift to left Lipopolysaccharide endotoxin is responsible for leucopenia and splenomegaly Relative bradycardia despite of high fever REf: Sabiston 20th edition Pgno: 1266
Perforation peritonitis due to a intestinal tuberculosis
Generalized peritonitis due to appendicular perforation
Typhoid enteric perforation and peritonitis
Acute salpingo-oophoritis with peitonitis
G.I.T