Work

Salmonella Enteritis Presenting as Acute Small Bowel Obstruction: An Infectious Roadblock With Endoscopic Correlation

Year: 2026

Type: article

Abstract: CASE REPORT A 68-year-old man with hypertension and dyslipidemia presented to the hospital with acute onset lower abdominal pain with concomitant nausea and vomiting after a brief episode of watery diarrhea. Computerized tomography of abdomen and pelvis demonstrated terminal ileal thickening, mucosal hyperenhancement, luminal narrowing, and upstream dilation consistent with small bowel obstruction (SBO) (Figure 1). Colonoscopy performed after nasogastric decompression to assess the underlying case of SBO revealed ulcerations and erosions in the terminal ileum and ascending colon (Figure 2), with biopsies revealing acute cryptitis without chronic inflammatory changes. Stool cultures confirmed Salmonella infection. Conservative management with intravenous fluids, bowel rest, and intravenous piperacillin/tazobactam led to clinical improvement. He was discharged on oral ciprofloxacin. Follow-up colonoscopy 2 months later demonstrated complete resolution of mucosal lesions, with biopsies showing no residual inflammation (Figure 3). This case underscores the importance of considering infectious etiologies in SBO, particularly in patients without prior abdominal surgery or Crohn's disease. Salmonella typically causes self-limited gastroenteritis, but in rare instances can induce severe terminal ileitis leading to obstruction.1,2 Our case uniquely demonstrates endoscopic correlation of Salmonella ileitis with changes that mimicked inflammatory bowel diseases at the onset of infection and complete resolution seen after antibiotic use.Figure 1.: CT abdomen/pelvis showing evidence of small bowel obstruction in the setting of a transition point in the terminal ileum associated with mucosal hyperenhancement. CT, computerized tomography.Figure 2.: Showing erosions and ulcerations in the terminal ileum.Figure 3.: Showing resolution of inflammatory changes in the terminal ileum after antimicrobial treatment.DISCLOSURES Author contributions: E. Zahid: Literature search, manuscript writing, and editing. Z. Bayat: Literature search. A. ur Rahman: Manuscript editing and is the article guarantor. Financial disclosure: AuR: Speaker for Abbvie Inc. Informed consent was obtained for this case report.

Source: ACG Case Reports Journal

DOI: 10.14309/crj.0000000000001974

Authors: Effa Zahid, Zubair Bayat, Asad ur Rahman

Institution: Cleveland Clinic Florida

Language: English

Topic: Salmonella and Campylobacter epidemiology

Subfield: Food Science

Field: Agricultural and Biological Sciences

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: AbbVie