Ileostomía en asa derivativa y lavado colónico intraoperatorio como alternativa de tratamiento en un caso de colitis grave por Clostridium difficile
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Felipe Quezada [1] ; Richard Castillo [1] ; Constanza Villalón [1] ; José Miguel Zúñiga ; Carla Manterola [1] ; María Elena Molina [1] ; Felipe Bellolio [1] ; Gonzalo Urrejola [1]
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[1] Pontificia Universidad Católica de Chile
Pontificia Universidad Católica de Chile
Santiago, Chile
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- Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 143, Nº. 5, 2015, págs. 668-672
- Idioma: español
- Títulos paralelos:
- Treatment of a severe Clostridium difficile infection with colonic lavages. Report of one case
- Enlaces
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Resumen
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.
