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小肠艰难梭菌的罕见表现:一例病例报告及文献综述

Uncommon Presentation of Clostridioides difficile in the Small Bowel: A Case Report and Review of Literature.

作者信息

Tah Sunanda, Khan Saqib, Kashyap Sarang

机构信息

Surgery, Saint James School of Medicine, Arnos Vale, VCT.

Surgery, Beckley Appalachian Regional Healthcare (ARH) Hospital, Beckley, USA.

出版信息

Cureus. 2023 Aug 14;15(8):e43460. doi: 10.7759/cureus.43460. eCollection 2023 Aug.

Abstract

infection (CDI) is a prevalent source of hospital-acquired diarrhea. The most common presentation of CDI is colitis. In cases of fulminant colitis/toxic megacolon, a colectomy and end ileostomy are part of the treatment plan. There is evidence to suggest that it may be beneficial to surgically treat severe complex CDI by constructing a loop ileostomy for fecal stream diversion followed by colonic lavage, also referred to as the Pittsburgh protocol, which has demonstrated decreased death rates in this patient population. In our case study, we present a rare case of a 60-year-old female patient diagnosed with fulminant small bowel CDI requiring resection of the necrotic small bowel. This was followed by creating an ileostomy and the Pittsburgh protocol, leading to a complete recovery. With an increasing incidence of CDI, it is important to be aware of the small bowel  infection and its treatment.

摘要

艰难梭菌感染(CDI)是医院获得性腹泻的常见病因。CDI最常见的表现是结肠炎。在暴发性结肠炎/中毒性巨结肠的病例中,结肠切除术和末端回肠造口术是治疗方案的一部分。有证据表明,通过构建袢式回肠造口术进行粪便转流,随后进行结肠灌洗,即所谓的匹兹堡方案,手术治疗严重复杂的CDI可能有益,该方案已证明可降低该患者群体的死亡率。在我们的病例研究中,我们展示了一例罕见病例,一名60岁女性患者被诊断为暴发性小肠CDI,需要切除坏死的小肠。随后进行了回肠造口术并采用了匹兹堡方案,患者完全康复。随着CDI发病率的增加,了解小肠感染及其治疗方法很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d501/10498804/20964f376b3e/cureus-0015-00000043460-i01.jpg

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