The Yersinia Enterocolitica Infection in Acute Abdominal Surgery

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Abstract
By estimation of antibody titers or possibly isolation of the microorganism, the role of Y. enterocolitica as an etiological agent in mesenterial lymphadenitis, ileal inflammation or abdominal colics was evaluated in 94 consecutive patients (25 operated upon and 69 treated conservatively) over 1 yr period from 1975-1976. Eighty-four patients (24 operated upon and 60 treated conservatively) were reexamined 5 yr later. Among the 25 patients operated upon, 3 presented acute terminal ileitis, 2 of them in association with acute Y. enterocolitica infection. A substantial part of the 22 patients with other peroperative findings also presented trace or positive Y. enterocolitica antibody titers. Some of these patients experienced complaints attributable to the Y. enterocolitica infection over the following years. At reexamination, previously elevated Y. enterocolitica antibody titers had generally normalized; in the 2 patients who in 1975 presented acute terminal ileitis associated with acute Y. enterocolitica infection, radiological examination demonstrated normal terminal ileum. Among 69 patients treated conservatively for abdominal colics, 36 in 1975 presented trace or positive titers. Over a 5 yr followup, abdominal pain and joint complaints were significantly more commonly experienced by patients with trace or positive titers than by patients with negative titers (P = 0.007 and P = 0.004, respectively). Y. enterocolitica is an important cause of abdominal disease in this region; the infection commonly gives symptoms of long duration.