A Case of Colonic Pseudoobstruction Related to Bacterial Overgrowth Due to a Sigmoidocecal Fistula.
10.4166/kjg.2014.63.2.125
- Author:
Kyoung Myeun CHUNG
1
;
Seong Uk LIM
;
Hyoung Ju HONG
;
Seon Young PARK
;
Chang Hwan PARK
;
Hyun Soo KIM
;
Sung Kyu CHOI
;
Jong Sun REW
Author Information
1. Department of Internal Medicine, Chonnnam National University Medical School, Gwangju, Korea. drpsy@naver.com
- Publication Type:Case Reports
- Keywords:
Colonic pseudo-obstruction;
Intestinal fistula;
Diverticulum;
Colon
- MeSH:
Aged;
Anti-Bacterial Agents/therapeutic use;
Breath Tests;
Colonic Pseudo-Obstruction/*diagnosis/etiology;
Colonoscopy;
Humans;
Intestinal Fistula/*diagnosis/drug therapy/microbiology;
Male;
Methane/chemistry/metabolism;
Tomography, X-Ray Computed
- From:The Korean Journal of Gastroenterology
2014;63(2):125-128
- CountryRepublic of Korea
- Language:English
-
Abstract:
Colocolic fistulas are usually a complication of an inflammatory or neoplastic process. Development of these abnormal bowel communications may lead to bacterial overgrowth. We report on a 71-year-old man with a one-year history of recurrent abdominal distension and irregular bowel habits. Abdominal X-rays and computed tomography showed multiple air-fluid levels and loops of distended bowel without evidence of mechanical obstruction or diverticulitis. Colonoscopy showed a fistulous tract between the sigmoid colon and cecum. Results of a lactulose breath test showed high fasting breath CH4 levels, which were thought to be the result of intestinal bacterial overgrowth. The patient was diagnosed with a colonic pseudo-obstruction associated with bacterial overgrowth due to a sigmoidocecal fistula. We recommended surgical correction of the sigmoidocecal fistula; however, the patient requested medical treatment. After antibiotic therapy, the patient still had mild symptoms but no acute exacerbations.
