Ileostomía en asa derivativa y lavado colónico intraoperatorio como alternativa de tratamiento en un caso de colitis grave por Clostridium difficile

A loop ileostomy with intraoperative anterograde colonic lavage has been described as an alternative to colectomy in the management of cases of Clostridium difficile infection refractory to medical treatment. We report a 69 years old diabetic women admitted with a septic shock. An abdominal CAT scan showed a pan-colitis that seemed to be infectious. A polymerase chain reaction was positive for Clostridium Difficile. Due to the failure to improve after full medical treatment, a derivative loop ileostomy and intra-operatory colonic lavage were performed, leaving a Foley catheter in the proximal colon. In the postoperative period, anterograde colonic instillations of Vancomycin flushes through the catheter were performed every 6 hours. Forty eight hours after surgery, the patient improved. A colonoscopy prior to discharge showed resolution of the pseudomembranous colitis.

Saved in:
Bibliographic Details
Main Authors: Quezada,Felipe, Castillo,Richard, Villalón,Constanza, Zúñiga,José Miguel, Manterola,Carla, Molina,María Elena, Bellolio,Felipe, Urrejola,Gonzalo
Format: Digital revista
Language:Spanish / Castilian
Published: Sociedad Médica de Santiago 2015
Online Access:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872015000500016
Tags: Add Tag
No Tags, Be the first to tag this record!