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A Rare Cause of Abdominal Pain; Yersinia Pseudotuberculosis

Year 2015, , 1 - 4, 07.09.2015
https://doi.org/10.5505/sakaryamj.2015.82473

Abstract

Yersinia pseudotuberculozis (YP) infection has increased especially in developed countries. YP rarely causes lymphadenitis and abdominal mass in the right lower quadrant that patient should be operated fort his reason. Our case is 12 years old girl with abdominal pain, vomiting that she has mass in the left quadrant. Firstly, diagnostic laparoscopy was performed, left lower quadrant mass was detected and laparotomy was performed. We thought that this mass could be YP during surgery because we detected lenfadenitis and abscess. Consequantly abscess drainage, mesentery and lymph node biopsy were done in laparotomy. The diagnosis was confirmed with seroloc and pathology. The patient was discharged on 10th day after surgery. The third postoperative month, the clinical and ultrasound findings were normal.Imaging techniques with long-term abdominal pain and abdomen mass in some patients are not sufficient for the differential diagnosis. YP should be considered in the differential diagnosis of masses that the surgeon's dilemma. Serological analysis will provide a correct diagnosis of the patients with YP and prevent to unnecessary surgical intervention.Key Words: Yersinia Psödotuberculosis; Abdominal Pain; Mass; Child

References

  • 1. Pallister C, Rotstein OD. Yersinia enterocolitica as a cause of intra-abdominal abscess: the role of iron. Can J Surg. 2001 Apr;44(2):135-6.
  • 2. Jelloul L, Fremond B, Dyon JF, et al. Mesenteric adenitis caused by Yersinia pseudotuberculosis presenting as an abdominal mass. Eur J Pediatr Surg. 1997;7:180–183.
  • 3. Tertti R, Vuento P, Mikkola P, et al. Clinical manifestation of Yersinia pseudotuberculosis infection in children. Eur J Microbiol Infect. 1989;8:587–591.
  • 4. Volk WA, Gebhardt BM, Hammaskjold MC, Kaomer RJ. Medical microbiology. Lippincott-Raven, Philadelphia, 1995;pp 236–264.
  • 5. Sue K, Nishimi T, Yamada T, Kamimura T, Matsuo Y, Tanaka N. A right lower abdominal mass due to Yersinia mesentery lymphadenitis. Pediatr Radiol 1994;24:70–71.
  • 6. Saari TN, Triplett DA. Yersinia pseudotuberculosis mesenteric adenitis. J Pediatr 1974;85:656–661.
  • 7. Van Noyen R, Selderslanghs R, Bekaert J. Causative role of Yersinia and other enteric pathogens in the appendicular syndrome. Eur J Clin Microbiol Infect Dis 1991;10:735–741.
  • 8. Kemper CA, Davis RE, Deresinski C, Dorfman F. Inflammatory pseudotumor of intra-abdominal lymph nodes manifesting as recurrent fever of unknown origin: a case report. Am J Med 1991;90:519–523.
  • 9. Larsen JH. Yersiniosis in children: diagnostic and clinical manifestations. Contrib Microbiol Immunol 1991;12:278– 281.
  • 10. Zippi M, Colaiacomo MC, Marcheggiano A, Pica R, Paoluzi P, Iaiani G, Caprili R, Maccioni F. Mesenteric adenitis caused by yersinia pseudotubercolosis in a patient subsequently diagnosed with Crohn’s disease of the terminal ileum. World J Gastroenterol 2006;12 (24):3933-3935.
  • 11. Volk WA, Gebhardt BM, Hammaskjold MC, Kaomer RJ. Medical microbiology. Lippincott-Raven, Philadelphia, (1995) pp 236–264.
  • 12. Krober MS, Bass JW, Barcia PJ. Scarlatiniform rash and pleural effusion in a patient with Yersinia pseudotuberculosis infection. J Pediatr 1983;102:879–881

Çocuklarda Nadir Bir Karında Kitle Nedeni; Yersinia Pseudotuberculosis

Year 2015, , 1 - 4, 07.09.2015
https://doi.org/10.5505/sakaryamj.2015.82473

Abstract

Yersinia pseudotuberculozis (YP) enfeksiyonu özellikle gelişmiş ülkelerde giderek artmaktadır. YP nadiren lenf adenit ve karında sağ alt kadranda kitleye neden olarak ameliyat edilmektedir. Olgumuz 12 yaşında kız hasta, kusma ve karın ağrısı nedeni ile yapılan incelemede (Fizik Muayene, Ultrasonografi ve Bilgisayarlı Tomografik değerlendirme) sol alt kadranda kitle tespit edilerek ameliyat edildi. Önce diagnostik laparoskopi yapıldı, sol kadranda kitle olduğu görüldü ve laparatomi yapılmasına karar verildi. Kitlenin abseleşmiş lenfadenit olması nedeniyle YP olabileceği düşünüldü. Laparotomide apse drenajı, mezenter ve lenf nodu biyopsisi alındı. Ameliyat sonrası tanı seroloji ve patoloji ile YP olarak doğrulandı. Hastanın tedavisi düzenlenip postoperatif 10 günde sorunsuz olarak taburcu edildi. Postoperatif üçüncü ay kontrolünde klinik ve ultrasonografi bulguları normaldi. Uzun süren karın ağrısı nedeni ile başvuran ve karnının herhangi bir bölgesinde kitle saptanan hastalarda bazen görüntüleme teknikleri ayırıcı tanıda yetersiz kalabilmektedir. Cerrahın ikilemde kaldığı bu kitlelerde YP ayırıcı tanıda düşünülmelidir. Hastanın YP için serolojik analizinin yapılması doğru tanıyı sağlayacak ve gereksiz cerrahi girişimi engelleyecektir.Anahtar Kelimeler: Yersinia Psödotuberculosis; Karın Ağrısı; Kitle; Çocuk

References

  • 1. Pallister C, Rotstein OD. Yersinia enterocolitica as a cause of intra-abdominal abscess: the role of iron. Can J Surg. 2001 Apr;44(2):135-6.
  • 2. Jelloul L, Fremond B, Dyon JF, et al. Mesenteric adenitis caused by Yersinia pseudotuberculosis presenting as an abdominal mass. Eur J Pediatr Surg. 1997;7:180–183.
  • 3. Tertti R, Vuento P, Mikkola P, et al. Clinical manifestation of Yersinia pseudotuberculosis infection in children. Eur J Microbiol Infect. 1989;8:587–591.
  • 4. Volk WA, Gebhardt BM, Hammaskjold MC, Kaomer RJ. Medical microbiology. Lippincott-Raven, Philadelphia, 1995;pp 236–264.
  • 5. Sue K, Nishimi T, Yamada T, Kamimura T, Matsuo Y, Tanaka N. A right lower abdominal mass due to Yersinia mesentery lymphadenitis. Pediatr Radiol 1994;24:70–71.
  • 6. Saari TN, Triplett DA. Yersinia pseudotuberculosis mesenteric adenitis. J Pediatr 1974;85:656–661.
  • 7. Van Noyen R, Selderslanghs R, Bekaert J. Causative role of Yersinia and other enteric pathogens in the appendicular syndrome. Eur J Clin Microbiol Infect Dis 1991;10:735–741.
  • 8. Kemper CA, Davis RE, Deresinski C, Dorfman F. Inflammatory pseudotumor of intra-abdominal lymph nodes manifesting as recurrent fever of unknown origin: a case report. Am J Med 1991;90:519–523.
  • 9. Larsen JH. Yersiniosis in children: diagnostic and clinical manifestations. Contrib Microbiol Immunol 1991;12:278– 281.
  • 10. Zippi M, Colaiacomo MC, Marcheggiano A, Pica R, Paoluzi P, Iaiani G, Caprili R, Maccioni F. Mesenteric adenitis caused by yersinia pseudotubercolosis in a patient subsequently diagnosed with Crohn’s disease of the terminal ileum. World J Gastroenterol 2006;12 (24):3933-3935.
  • 11. Volk WA, Gebhardt BM, Hammaskjold MC, Kaomer RJ. Medical microbiology. Lippincott-Raven, Philadelphia, (1995) pp 236–264.
  • 12. Krober MS, Bass JW, Barcia PJ. Scarlatiniform rash and pleural effusion in a patient with Yersinia pseudotuberculosis infection. J Pediatr 1983;102:879–881
There are 12 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Turan Yıldız This is me

Fatih Kılıçbay This is me

Hatice Sağlam Fitöz This is me

Publication Date September 7, 2015
Submission Date September 7, 2015
Published in Issue Year 2015

Cite

AMA Yıldız T, Kılıçbay F, Fitöz HS. Çocuklarda Nadir Bir Karında Kitle Nedeni; Yersinia Pseudotuberculosis. Sakarya Tıp Dergisi. March 2015;5(1):1-4. doi:10.5505/sakaryamj.2015.82473

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