Siddiqui Zohaib, Siddiqui Zain Ahmed, Husain Fahd, Siddiqui Midhat
Medical Student, King's College London School of Medical Education, London, UK.
Foundation Year 1, Queen Elizabeth Hospital, London, UK.
BMJ Case Rep. 2017 Jun 8;2017:bcr-2017-219395. doi: 10.1136/bcr-2017-219395.
We report a case of chronic infection caused by 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 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 , 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.
我们报告一例肥胖患者在接受Roux-en-Y胃旁路术（RYGB）后由[细菌名称未给出]引起的慢性感染，并通过腹腔镜胆囊切除术治愈的病例。该患者有2年慢性腹痛、腹泻和体重过度减轻的病史。她的粪便和尿液培养物检测出[细菌名称未给出]呈阳性。尽管接受了多疗程抗生素治疗，她的检测结果仍为阳性。在接受腹腔镜胆囊切除术后，患者症状消失，粪便检测结果转为阴性。在[细菌名称未给出]的慢性携带者中，胆囊是细菌的常见储存部位，切除胆囊通常可治愈疾病。[细菌名称未给出]的来源可能在其减重手术的胆肠吻合支而非胆囊这一可能性仍令人担忧。对于接受过RYGB的患者，胆囊切除术是一种有效的治疗方法。所有RYGB术后出现腹部症状的患者都应进行粪便和尿液培养，作为其检查的一部分。
