Salmonella Gastritis Presenting as Acute Abdominal Pain

THE SEVERE abdominal pain that is occasionally associated with Salmonella gastroenteritis may not be appreciated by some physicians.¹ We recently cared for a patient with this disease who had the physical signs of a "surgical abdomen."

Report of a Case  A 21-year-old man had chills, fever, and nausea. This was followed the next day by crampy, diffuse abdominal pain and several loose bowel movements. He took antidiarrheal medication for 24 hours, and bowel movements ceased. Over the next 36 hours, an increasingly severe, steady pain developed in the right lower quadrant of the abdomen. On admission, rectal temperature was 38.9 C and the pulse rate was 68 beats per minute. The abdomen was flat, and bowel sounds were absent. Severe hyperesthesia and direct and rebound tenderness in the right lower quadrant were striking findings. Rebound tenderness was referred to the right lower quadrant on palpation of the entire abdomen.