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A literature review and case report of severe and refractory post-colectomy enteritis.

Authors :
Yang, Yingyun
Liu, Yuan
Zheng, Weiyang
Zhou, Weixun
Wu, Bin
Sun, Xiyu
Chen, Wei
Guo, Tao
Li, Xiaoqing
Yang, Hong
Qian, Jiaming
Li, Yue
Source :
BMC Gastroenterology. 4/25/2019, Vol. 19 Issue 1, pN.PAG-N.PAG. 1p. 3 Color Photographs, 1 Diagram, 1 Chart.
Publication Year :
2019

Abstract

<bold>Background: </bold>Ulcerative colitis (UC)-related post-colectomy enteritis is a very rare condition that is characterized by diffuse small-bowel mucosal inflammation following colectomy and could be very dangerous. In previously reported cases, corticosteroid therapy seemed to be the optimal choice for inducing remission; however, the patient studied herein presented with severe diarrhoea and hypovolemic shock and failed to achieve full remission with corticosteroid therapy.<bold>Case Presentation: </bold>We describe the case of a patient with severe pan-enteritis presenting with life-threatening diarrhoea complicated with hypovolemic shock and acute kidney injury after colectomy and ileal pouch anal anastomosis (IPAA) for UC; this patient was successfully treated by ileostomy closure after failing to achieve full remission with corticosteroid therapy. Next, we review other cases of post-colectomy enteritis reported in the literature and propose a flow-chart for its diagnosis and initial treatment.<bold>Conclusion: </bold>Post-colectomy enteritis can be dangerous, and the early awareness of this condition plays a vital role. Additionally, in patients who do not respond well to corticosteroid or immunosuppressant therapy, early closure of the ileostomy and re-establishment of the natural faecal stream could be important considerations. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
1471230X
Volume :
19
Issue :
1
Database :
Academic Search Index
Journal :
BMC Gastroenterology
Publication Type :
Academic Journal
Accession number :
136097855
Full Text :
https://doi.org/10.1186/s12876-019-0974-4