Fecal peritonitis

Case contributed by Rodney Strahan
Diagnosis certain


Traveled 300 kms by public transport, suffering from abdominal pain.

Patient Data

Age: 20 years
Gender: Male

Soft tissue density material in paracolic gutters, medial to properitoneal fat planes, displacing bowel medially. Free gas is seen as 'football sign'.


Ultrasound demonstrates echogenic material in the peritoneal cavity, around the spleen and in the paracolic gutters.

Case Discussion

Distal ileal perforations were found at laparotomy, typical of typhoid fever. There was gross fecal contamination of the peritoneal cavity.

The patient survived the operation but succumbed to overwhelming sepsis.

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