The Yersinia enterocolitica infection in acute abdominal surgery. A clinical study with a 5-year follow-up period.
By estimation of antibody titres or possibly isolation of the micro-organism, the role of the Yersinia 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) during a 1-year period from 1975-76. Eighty four patients (24 operated upon and 60 treated conservatively) were re-examined 5 years later. Among the 25 patients operated upon, three presented acute terminal ileitis, two 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 titres. Some of these patients experienced complaints attributable to the Y. enterocolitica infection over the following years. At re-examination, previously elevated Y. enterocolitica antibody titres had generally normalized, and in the two patients who in 1975 presented acute terminal ileitis associated with acute Y. enterocolitica infection, radiological examination now demonstrated normal terminal ileum. Among 69 patients treated conservatively for abdominal colics, 36 in 1975 presented trace or positive titres. During the 5-year follow-up period, abdominal pain and joint complaints were significantly more commonly experienced by patients with trace or positive titres than by patients with negative titres (p = 0.007 and p = 0.004, respectively). The Y. enterocolitica is an important cause of abdominal disease in our region, and the infection commonly gives symptoms of long duration.