Perforation due to ileocaecal salmonellosis

A 54-year old male patient was admitted with a tentative diagnosis of biliary pancreatitis. After 3 days, he developed an acute abdomen with a pneumoperitoneum. A laparotomy was performed : multiple perforations of the terminal ileum and a necrotic gallbladder were found. A right hemicolectomy with 30 cm of the terminal ileum and a cholecystectomy were carried out. At the same time, positive blood cultures for Salmonella typhi were obtained and this confirmed the diagnosis of ileal perforation due to salmonella typhi infection. This case illustrates that Salmonella typhi infection can be a surgical problem in the western countries.