Campylobacter jejuni Enteritis Mimicking Mechanical Small Bowel Obstruction

TL;DR

An elderly patient's Campylobacter infection caused symptoms resembling a bowel blockage, which resolved with antibiotics.

Contribution

Highlights a rare case where C. jejuni enteritis mimics mechanical small bowel obstruction on imaging.

Findings

C. jejuni enteritis can mimic mechanical SBO due to bowel thickening and edema.

The patient's symptoms resolved with azithromycin and conservative treatment.

Imaging showed a clear transition point, initially suggesting mechanical obstruction.

Abstract

In this case, we present an 84-year-old patient admitted for small bowel obstruction (SBO) with radiographic evidence of a clear transition point in the proximal small bowel on a computed tomography (CT) scan. Given his prior history of hemicolectomy, surgical adhesions were suspected as the likely cause. After several days of poor response to supportive treatment, he developed significant secretory diarrhea with stool samples positive for Campylobacter jejuni. In rare cases, C. jejuni enteritis can mimic SBO. We suggest that his SBO initially resembled mechanical obstruction on imaging due to significant bacterial induced circumferential bowel thickening and edema as opposed to the usual pseudo-obstruction from bacterial activated pro-inflammatory mediators, which disrupt intestinal motility. His obstruction resolved with a course of azithromycin antibiotics and conservative measures.

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