Kim Ho Seung, Kang Jae Hyun, Kim Han-Gil, Kim Young Hun, Bae Hyeonwoo, Kim Nam Kyu
Division of Colorectal Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Ann Coloproctol. 2021 Jul;37(Suppl 1):S4-S6. doi: 10.3393/ac.2019.09.24. Epub 2020 Mar 16.
Clostridium difficile infection (CDI) after ileostomy reversal is rare, with few reports available in the available literature describing this condition. The diagnosis of CDI after ileostomy reversal is challenging because symptoms such as diarrhea observed in these patients can occur frequently after surgery. However, CDI can be fatal, so early diagnosis and prompt treatment are important. We discuss 2 patients with positive C. difficile toxin assay results on stool cultures performed after ileostomy reversal. Clinical progression differed between these patients: one patient who presented with severe CDI and shock was successfully treated following a prolonged intensive care unit stay for the management of vital signs and underwent hemodialysis, while another patient showed symptoms of mild colitis but we could not confirm whether diarrhea was associated with CDI or with the usual postoperative state. To our knowledge, these represent 2 of just a few cases reported in the literature describing CDI after ileostomy reversal.
回肠造口术逆转后发生艰难梭菌感染（CDI）很罕见，现有文献中关于这种情况的报道很少。回肠造口术逆转后CDI的诊断具有挑战性，因为这些患者出现的腹泻等症状在术后可能经常发生。然而，CDI可能是致命的，所以早期诊断和及时治疗很重要。我们讨论2例在回肠造口术逆转后进行的粪便培养中艰难梭菌毒素检测结果呈阳性的患者。这两名患者的临床病程有所不同：一名出现严重CDI和休克的患者在重症监护病房长时间住院以维持生命体征并接受血液透析后成功治愈，而另一名患者表现出轻度结肠炎症状，但我们无法确定腹泻是与CDI有关还是与通常的术后状态有关。据我们所知，这是文献中报道的回肠造口术逆转后CDI的少数病例中的2例。
