ABSTRACT
Postoperative adhesions are commonly seen after most abdominal surgeries. The majority of patients with intra-abdominal adhesions remain asymptomatic; however, some patients may develop symptoms ranging from mild abdominal pain to sometimes life-threatening complications. The most severe complication seen in association with postoperative adhesions is small bowel obstruction (SBO). This complication is rarely seen in the pediatric age-group. Adhesions have the potential to cause bowel obstruction. In addition, they can also affect the normal intestinal motility and transit leading to constipation. Several studies reported in literature show a strong association between constipation and the urinary disorders, such as incontinence and urinary urgency. We herein report a case of a boy who developed adhesive SBO with segmental ileal dilatation leading to constipation, urinary symptoms, and finally presenting to our hospital as acute urinary retention. How to cite this article: Zaki SA, Banur D, Chaudhary N, Gebran S. Postoperative Adhesive Small Bowel Obstruction Presenting as Acute Urinary Retention. Indian J Crit Care Med 2022;26(6):739-741.
ABSTRACT
Inflammatory myofibroblastic tumor (IMT) is associated in 15-30% of cases with systemic symptomatology, such as prolonged fever, weight loss, elevated erythrocyte sedimentation rate (ESR), anemia, thrombocytosis, and leukocytosis. We report the case of a 4-year-old Lebanese boy who presented with high-grade fever of long duration, and a single (unpaired) positive Widal agglutination test. Blood culture was negative. A diagnosis of typhoid fever was made. An abdominal (mesenteric) IMT was incidentally discovered, 30 days after the fever had appeared. After surgery, the fever disappeared immediately, and the ESR returned to normal. We strongly favor the possibility of a false positive Widal test, due to polyclonal increase in serum immunoglobulins, which often occurs in IMT. We also think that IMT might be a mimicker of typhoid fever, both clinically and serologically. Physicians, especially pediatricians practicing in endemic areas, should probably be aware of this mimicry.
