Preston F W, Svoboda A C, Horvath S M
Am J Surg. 1978 May;135(5):710-3. doi: 10.1016/0002-9610(78)90143-5.
Ileostomy of the distal end of the bypassed segment of small intestine was done twenty-three months after a 28 to 20 cm (12 to 8 inch) end-to-end jejunoileal bypass for obesity (Scott operation) in a forty-eight year old white female, thus creating a Thiry fistula. Weight prior to jejunoileal bypass was 130 kg (287 pounds). Before ileostomy it had stabilized at 80.3 kg (177 pounds). Indications for ileostomy were three episodes of blind loop syndrome and three episodes of severe bleeding from the ileotransverse colostomy anastomotic site. Culture of the bypassed segment at laparotomy revealed bacteroides, clostridia, and other anaerobes as well as the usual aerobic large bowel flora. After ileostomy the bypassed segment contained no anaerobic bacteria. Daily fluid output from the ileostomy has decreased with time, averaging 436 ml per day for the first postileostomy month and 50 ml per day for the ninth month. Beneficial effects of the ileostomy include: (1) better sense of well being; (2) no further episodes of blind loop syndrome or intestinal bleeding; and (3) cessation of anal itching. Nine months after ileostomy, hyperoxaluria and acquired megacolon were present. Weight was 5.9 kg (13 pounds) greater than before ileostomy.
在一名48岁白人女性因肥胖接受28至20厘米（12至8英寸）空肠回肠端端吻合术（斯科特手术）23个月后，对旁路小肠远端进行了回肠造口术，从而形成了一个蒂里瘘。空肠回肠旁路术前体重为130千克（287磅）。回肠造口术前体重稳定在80.3千克（177磅）。回肠造口术的指征是三次盲袢综合征发作和回肠横结肠造口吻合部位三次严重出血。剖腹手术时对旁路肠段进行培养，发现有拟杆菌、梭菌和其他厌氧菌以及常见的需氧大肠菌群。回肠造口术后，旁路肠段未发现厌氧菌。回肠造口术的每日液体排出量随时间减少，回肠造口术后第一个月平均每天436毫升，第九个月平均每天50毫升。回肠造口术的有益效果包括：（1）感觉更好；（2）未再出现盲袢综合征或肠道出血；（3）肛门瘙痒停止。回肠造口术九个月后，出现高草酸尿症和后天性巨结肠。体重比回肠造口术前重5.9千克（13磅）。
