Chowdhry Saleem, Katz Jeffry A
Division of Gastroenterology and Liver Disease, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH, 44106-5066, USA,
Curr Infect Dis Rep. 2014 Dec;16(12):442. doi: 10.1007/s11908-014-0442-9.
Pouchitis is an inflammatory complication after restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA). IPAA is the surgical treatment of choice in patients with ulcerative colitis (UC) who require colectomy. Initial episodes of acute pouchitis generally respond to antibiotics but significant numbers of cases eventually become dependent on or refractory to antibiotics. Management of chronic antibiotic refractory pouchitis is challenging and can ultimately lead to pouch failure. The etiopathogenesis is unknown though recent studies have implicated bacterial dysbiosis of the pouch microbiota, NOD2 polymorphism, and Clostridium difficile infection in the development of severe pouchitis. Early identification of risk factors can help in tailoring therapy and reducing cases of chronic pouchitis.
袋炎是结直肠切除回肠储袋肛管吻合术（IPAA）后的一种炎症性并发症。IPAA是需要行结肠切除术的溃疡性结肠炎（UC）患者的首选手术治疗方式。急性袋炎的初始发作通常对抗生素有反应，但相当数量的病例最终会对抗生素产生依赖或耐药。慢性抗生素难治性袋炎的管理具有挑战性，最终可能导致储袋功能衰竭。尽管最近的研究表明储袋微生物群的细菌失调、NOD2多态性和艰难梭菌感染与严重袋炎的发生有关，但其发病机制尚不清楚。早期识别危险因素有助于调整治疗方案并减少慢性袋炎的病例。
