A Case Report of Escherichia Coli O157 Infection, Which was Difficult to Discriminate from Intussusception

Yuichi Ishida, Susumu Kobayashi, Akihiko Hara, Yoji Yamazaki and Teruaki Aoki

Department of Surgery, The Jikei University School of Medicine

A 20-year-old woman was admitted to our hospital because of nausea and severe abdominal pain without bloody stool or diarrhea. An elastic-soft clubbing mass was seen in the right mid and lower abdomen which exhibited rebound tenderness. Abdominal ultrasonography (US) and computed tomography (CT) showed a target-like appearance. Preoperative diagnosis of intussusception was not verified in surgery, so we conducted an appendectomy. On postoperative day 2, Escherichia coli O157 was detected from the feces. With no symptoms of bloody stool or diarrhea, Escherichia coli O157 may be difficult to distinguish from intussusception. A differential diagnosis requires a detailed family history, introduction of rapid and appropriate testing for detecting O157 in the stool, and ultrasound color doppler examination.

Key words
Escherichia coli O157, verotoxin, hemorrhagic colitis

Reprint requests
Yuichi Ishida Department of Surgery, The Jikei University School of Medicine 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461 JAPAN

Accepted
November 29, 2000

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