A Case of Acute Abdomen Caused by Enteroaggregative Escherichia coli

Background: Surgeons are often challenged to make operative decisions in patients with acute abdominal pain. Recognition that an acute abdomen is a rare presentation of infectious colitis may prevent unnecessary operation. We present a patient with acute abdomen found to be from procto-colitis caused by enteroaggregative Escherichia coli. Case Presentation: A 56-year-old woman was seen for acute severe diffuse abdominal pain. She had a single episode of watery diarrhea. She had exquisite tenderness of the right side of the abdomen and lactic acidosis. She was afebrile and did not have leukocytosis. Computed tomography (CT) imaging showed thickening and inflammation extending from the right colon to the rectum. She was treated with bowel rest and antibiotic therapy. She was suspected of having an infectious colitis and stool cultures grew enteroaggregative Escherichia coli and no other enteric pathogens. She responded and was discharged in four days. Conclusion: Non-operative treatment of patients with acute abdominal pain caused by an infectious colitis should be considered. Despite having severe abdominal pain and lactic acidosis, our patient with enteroaggregative Escherichia coli procto-colitis responded to antibiotics and bowel rest.