We report a case of chronic infection caused by Salmonella and cured by a laparoscopic cholecystectomy after Roux-en-Y gastric bypass (RYGB) surgery for obesity. This patient presented with a 2-year history of chronic abdominal pain, loose stools and excessive weight loss. Her stool and urine cultures were positive for Salmonella. Despite multiple courses of antibiotics, she remained positive.
After undergoing a laparoscopic cholecystectomy, the patient became asymptomatic and stools remained negative. In chronic carriers for Salmonella, the gall bladder is the common reservoir for the bacteria and removing it is usually curative.
The possibility that the source of the may be in the biliary limb of her bariatric procedure and not in the gall bladder remained a concern.
In patients who have had a RYGB, cholecystectomy is an effective treatment.
All patients presenting with abdominal symptoms following RYGB should have stool and urine cultures taken as part of their work up.
A case of a chronic slamonella infection following Roux-en-Y gastric bypass surgery, treated successfully by a laparoscopic cholecystectomy
MBJ Case Reports, 2017, Zohaib Siddiqui, Zain Ahmed Siddiqui, Fahd Husain, Midhat Siddiqui, doi:10.1136/bcr-2017-219395