A STUDY ON CLOSTRIDIUM ENTERITIS DEVELOPED AFTER SURGERY FOR GASTROINTESTINAL DISEASE
In order to elucidate the risk factors of clostridium difficile colitis, 149 patients undergoing cholecystectomy for benign disease and 371 patients undergoing digestive tract operation from January 1999 to December 2001 are enrolled in this study. We diagnosed the patients as having the disease whe...
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Published in | Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 65; no. 11; pp. 2843 - 2847 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Japan Surgical Association
2004
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Abstract | In order to elucidate the risk factors of clostridium difficile colitis, 149 patients undergoing cholecystectomy for benign disease and 371 patients undergoing digestive tract operation from January 1999 to December 2001 are enrolled in this study. We diagnosed the patients as having the disease when they presented with high fever followed by diarrhea after surgery and showed positive response with Clostridium toxin A detection kit. The incidence rate of this disease or diarrhea in the cholecystectomy group was significantly higher than that in the digestive tract operation group. In the cholecystectomy group, no significant differences in background factors such as operative procedure and age were noted between patients with and without symptoms of enteritis. However, a significantly higher incidence rate of the disease was noted in patients received examination or internal treatments including fasting and i. v. drip infusion of antibiotics and H2-blockers than that in preoperatively non-treated patients. There is a recent tendency to select early operation for acute cholecystitis. We think that early operation is desirable in terms of an increasing tendency of risk of postoperative enteritis. |
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AbstractList | In order to elucidate the risk factors of clostridium difficile colitis, 149 patients undergoing cholecystectomy for benign disease and 371 patients undergoing digestive tract operation from January 1999 to December 2001 are enrolled in this study. We diagnosed the patients as having the disease when they presented with high fever followed by diarrhea after surgery and showed positive response with Clostridium toxin A detection kit. The incidence rate of this disease or diarrhea in the cholecystectomy group was significantly higher than that in the digestive tract operation group. In the cholecystectomy group, no significant differences in background factors such as operative procedure and age were noted between patients with and without symptoms of enteritis. However, a significantly higher incidence rate of the disease was noted in patients received examination or internal treatments including fasting and i. v. drip infusion of antibiotics and H2-blockers than that in preoperatively non-treated patients. There is a recent tendency to select early operation for acute cholecystitis. We think that early operation is desirable in terms of an increasing tendency of risk of postoperative enteritis. |
ArticleNumber | 2843 |
Author | TSUBOI, Ken ITO, Akitoshi HATO, Motoki NAKAYAMA, Takuya KOBAYASHI, Kenji KAMIYA, Yasuhiro |
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References | 1) 松浦伸二郎:偽膜性大腸炎.山口医会誌 32: 102, 1998 2) 星加和徳:偽膜性腸炎(Clostridium difficile感染症).別冊日本臨牀領域別症候群シリーズ, 23,感染症症候群I,日本臨牀社,大阪, 1999, p24-26 5) 炭山嘉伸:消化器外科感染症における腸内細菌の重要性.日消外会誌 30: 121-125, 1997 6) 森藤雅彦,竹末茂生,大毛宏喜:消化管運動機能障害を呈した偽膜性腸炎の1例.日本大腸肛門病会誌 53: 216-220, 2000 4) 安達桂子: CDチェック.臨床と微生物 22: 687-690, 1995 7) Pereira SP, Gainsborough N, Dowling RH: Drug-induced hypochlorhydria causes high duodenal bacterial counts in the elderly. Aliment Pharmacol Ther 12: 99-104, 1998 9) Madan AK, Aliabadi-Wahle S, Tesi D, et al: How early is early laparoscopic treatment of acute cholecystitis? The American Journal of Surgery 183: 232-236, 2002 8) Greenwald JA, Mcmullen HF, Coppa GF, et al: Standardization of surgeon-controlled variables impact on outcome in patients with acute cholecystitis. Annals of surgery 231: 339-344, 2000 3) 斉藤裕輔,渡 二郎,藤谷幹浩:薬剤性腸炎の起因薬剤と病態・発生機序.胃と腸 35: 1117-1123, 2000 |
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