Abstract：
BACKGROUND: Small intestinal bacterial overgrowth (SIBO) is a condition of unknown prevalence characterized by an excessive amount of bacteria in the small bowel, typically resulting in vague gastrointestinal symptoms with bloating being most commonly reported. Here we describe a severe case of SIBO leading to small bowel necrosis requiring surgical intervention.
METHODS: A 55-year-old Hispanic female with gastric outlet obstruction secondary to a newly diagnosed gastric adenocarcinoma, receiving neoadjuvant chemotherapy, developed bloody gastrostomy output and rapidly progressing nausea and abdominal distention 3 days after jejunostomy tube placement and initiation of jejunal enteral nutrition. Imaging revealed diffuse pneumatosis and portal venous gas. Surgical exploration confirmed segmental bowel necrosis requiring resection. Histologic findings were consistent with SIBO.
CONCLUSIONS: Presentation of severe SIBO in the setting of intestinal stasis secondary to gastric outlet after initiation of enteral feeds is a rare phenomenon. Early recognition and diagnosis of SIBO is critical in minimizing patient morbidity and mortality.
METHODS: A 55-year-old Hispanic female with gastric outlet obstruction secondary to a newly diagnosed gastric adenocarcinoma, receiving neoadjuvant chemotherapy, developed bloody gastrostomy output and rapidly progressing nausea and abdominal distention 3 days after jejunostomy tube placement and initiation of jejunal enteral nutrition. Imaging revealed diffuse pneumatosis and portal venous gas. Surgical exploration confirmed segmental bowel necrosis requiring resection. Histologic findings were consistent with SIBO.
CONCLUSIONS: Presentation of severe SIBO in the setting of intestinal stasis secondary to gastric outlet after initiation of enteral feeds is a rare phenomenon. Early recognition and diagnosis of SIBO is critical in minimizing patient morbidity and mortality.
摘要：
背景：小肠细菌过度生长（SIBO）是一种未知流行的疾病，其特征是小肠中细菌过多，通常导致模糊的胃肠道症状，腹胀是最常见的报道。在这里，我们描述了SIBO导致小肠坏死的严重病例，需要手术干预。
方法：一名55岁的西班牙裔女性，继发于新诊断的胃腺癌，患有胃出口梗阻，接受新辅助化疗，空肠造口管放置和空肠肠内营养开始后3天，出现了流血的胃造口术输出和快速进展的恶心和腹胀。影像学显示弥漫性肺炎和门静脉气体。手术探查证实节段性肠坏死，需要切除。组织学结果与SIBO一致。
结论：在开始肠内喂养后继发于胃出口的肠淤滞中，出现严重的SIBO是一种罕见的现象。SIBO的早期识别和诊断对于最小化患者发病率和死亡率至关重要。
方法：一名55岁的西班牙裔女性，继发于新诊断的胃腺癌，患有胃出口梗阻，接受新辅助化疗，空肠造口管放置和空肠肠内营养开始后3天，出现了流血的胃造口术输出和快速进展的恶心和腹胀。影像学显示弥漫性肺炎和门静脉气体。手术探查证实节段性肠坏死，需要切除。组织学结果与SIBO一致。
结论：在开始肠内喂养后继发于胃出口的肠淤滞中，出现严重的SIBO是一种罕见的现象。SIBO的早期识别和诊断对于最小化患者发病率和死亡率至关重要。
