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  • In trauma, expect the unexpected: a rare case of post-traumatic pancreatitis associated with salmonellosis and enterocolitis

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Unusual association of diseases/symptoms
CASE REPORT
In trauma, expect the unexpected: a rare case of post-traumatic pancreatitis associated with salmonellosis and enterocolitis
  1. Nadja Apelt,
  2. Emily Thompson,
  3. Erica Brown,
  4. David Schindel
  1. Department of Pediatric Surgery, Children’s Health Children’s Medical Center Dallas, Dallas, Texas, USA
  1. Correspondence to Dr Nadja Apelt, nadja.apelt{at}med.uni-rostock.de

Summary

A 16-year-old Hispanic man was transferred to our level I paediatric trauma centre with pancreatitis. Ten days prior, he had sustained a gunshot wound to the abdomen requiring an exploratory laparotomy for repair of a traumatic left diaphragmatic injury. Additional injuries included gastric, renal, liver and pancreatic lacerations as well as a T12 burst fracture that resulted in paraplegia. Conservative management of pancreatitis was unsuccessful over the next 10 days, resulting in progressive symptoms of severe unresolved pain, nausea, emesis and rising lipase. Workup for post-traumatic, biliary and drug-associated causes of pancreatitis was negative, and no anatomical abnormalities were found on imaging. A fever workup on hospital day 10 revealed a urinary tract infection with non-typhoid Salmonella sp, and subsequent stool and imaging studies revealed salmonellosis associated with right-sided colitis and Clostridium difficile infection. Pancreatitis resolved within 48 hours following treatment of salmonellosis and Clostridium.

  • trauma
  • infection (gastroenterology)
  • pancreatitis
  • pancreas and biliary tract
  • global health

https://doi.org/10.1136/bcr-2018-226286

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    Footnotes

    • Contributors NA: is the principal author of the paper and has drafted the summary, background and case discussion as well as performed large parts of the literature research. ET, EB: have been responsible for drafting the case presentation, outcome and follow-up. DS: has aided in critically revising the manuscript, has aided in literature research and in defining the critical learning points. All four authors have contributed substantially to the conception of the work and helped both in acquiring and interpreting the data. All four authors have actively contributed to the drafting and revision of the manuscript, and all approve the final version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.