Wuhan Puren Hospital, Wuhan, Hubei, China.
Maintainbiotech. Ltd. (Wuhan), Wuhan, Hubei, China.
J Int Med Res. 2024 May;52(5):3000605241241000. doi: 10.1177/03000605241241000.
Ileostomy diverts the flow of feces, which can result in malnutrition in the distal part of the intestine. The diversity of the gut microbiota consequently decreases, ultimately leading to intestinal dysbiosis and dysfunction. This condition can readily result in diversion colitis (DC). Potential treatment strategies include interventions targeting the gut microbiota. In this case study, we effectively treated a patient with severe DC by ileostomy and allogeneic fecal microbiota transplantation (FMT). A 69-year-old man presented with a perforated malignant tumor in the descending colon and an iliac abscess. He underwent laparoscopic radical sigmoid colon tumor resection and prophylactic ileostomy. Follow-up colonoscopy 3 months postoperatively revealed diffuse intestinal mucosal congestion and edema along with granular inflammatory follicular hyperplasia, leading to a diagnosis of severe DC. After two rounds of allogeneic FMT, both the intestinal mucosal bleeding and edema significantly improved, as did the diversity of the gut microbiota. The positive outcome of allogeneic FMT in this case highlights the potential advantages that this procedure can offer patients with DC. However, few studies have focused on allogeneic FMT, and more in-depth research is needed to gain a better understanding.
回肠造口术可改变粪便的流向,从而导致肠道远端营养不良。肠道微生物多样性随之减少,最终导致肠道菌群失调和功能障碍。这种情况很容易导致回肠造口术相关结肠炎(DC)。潜在的治疗策略包括针对肠道微生物群的干预措施。在这个病例研究中,我们通过回肠造口术和同种异体粪便微生物群移植(FMT)成功治疗了一位严重 DC 患者。一名 69 岁男性因降结肠穿孔性恶性肿瘤和髂脓肿而就诊。他接受了腹腔镜根治性乙状结肠肿瘤切除术和预防性回肠造口术。术后 3 个月的结肠镜检查显示弥漫性肠黏膜充血和水肿,伴有颗粒状炎性滤泡增生,诊断为严重 DC。经过两轮同种异体 FMT 后,肠黏膜出血和水肿明显改善,肠道微生物多样性也得到改善。本病例中同种异体 FMT 的良好效果突显了该手术为 DC 患者带来的潜在优势。然而,目前针对同种异体 FMT 的研究较少,需要进行更深入的研究以加深了解。