Bowel obstruction due to Chlamydia trachomatis: a case report and review of literature

Abstract

Background: Chlamydial infection is a difficult-to-diagnose type of sexually transmitted disease that occurs mainly in young people. We report a case of bowel obstruction caused by intrapelvic adhesions formed by chlamydial infection.

Case presentation: This patient was a 23-year-old woman who had been suffering from acute abdominal pain. She had been previously treated several times for intrapelvic abscesses and had a history of chlamydial infection. Endometriosis was thought to be the cause of her pelvic abscess based on endoscopic findings. Computed tomography demonstrated a small bowel obstruction caused by a pelvic abscess. However, the diagnosis could not be confirmed. She underwent laparoscopic surgery and was diagnosed with bowel obstruction due to adhesion of chlamydial infection based on the intraoperative findings and Chlamydia trachomatis antibody test. She was discharged 5 days after surgery.

Conclusions: It is necessary to consider the possibility of chlamydial infection as a cause for lower abdominal pain and unexplained bowel obstruction in female patients.

Keywords: Bowel obstruction; Chlamydia trachomatis; Pelvic inflammatory disease.

Fig. 1

Abdominal CT and intraoperative findings. a arrow: Closed loop formed and dilated small intestine, arrowheads: Collapsed small intestine on the oral and anal sides of the closed loop, b ascites in the pelvis, c ascites in the pelvis and adhesion of the uterine appendages, and d adhesions that are translucent and considered to be in the active stage of chlamydial infection on the liver surface