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Access Microbiology 2023Extra-intestinal infection with non-O1/non-O139 strains of (NOVC) is rare, though bacteremia and hepatobiliary manifestations have been reported. Reduced stomach acid,...
Extra-intestinal infection with non-O1/non-O139 strains of (NOVC) is rare, though bacteremia and hepatobiliary manifestations have been reported. Reduced stomach acid, or hypochlorhydria, can increase risk of infection. We describe a 42-year-old woman with hypochlorhydria due to untreated infection, gastric-bypass surgery, and chronic proton pump inhibitors (PPI) exposure, who developed acute diarrhoea following raw oyster consumption. Her symptoms were attributed to rapid gastric emptying (dumping syndrome) after a negative limited stool work-up. She had persistent diarrhoea, weight loss, and after 5 months was admitted with acute cholecystitis and NOVC bacteremia, requiring cholecystectomy. This is the first reported case of NOVC bacteremia and cholecystitis in a patient with gastric bypass. This case highlights the potential for NOVC biliary carriage, the role of hypochlorhydria as a risk factor for infection, and the importance of excluding infectious diarrhoea in patients with new onset of symptoms compatible with dumping syndrome and a relevant travel history.
PubMed: 37970081
DOI: 10.1099/acmi.0.000517.v3 -
Malaysian Family Physician : the... 2024
PubMed: 38496771
DOI: 10.51866/lte.514 -
In Vivo (Athens, Greece) 2024Based on gastric shape, patients with gastric cancer can be divided into storage (hook-shaped and ptotic stomach) and reverse outflow (steer-horn and cascade stomach)...
BACKGROUND/AIM
Based on gastric shape, patients with gastric cancer can be divided into storage (hook-shaped and ptotic stomach) and reverse outflow (steer-horn and cascade stomach) groups. In patients with gastric cancer, postoperative loss of lean body mass (LBM) is associated with a poor prognosis. This study investigated the influence of preoperative gastric shape on LBM loss 1 month after curative distal gastrectomy.
PATIENTS AND METHODS
Between May 2011 and May 2019, we enrolled 487 patients with pathological stage IA/IB/IIA gastric cancer who underwent curative distal gastrectomy and did not receive adjuvant chemotherapy. Patients were divided into storage (n=370) and outflow (n=117) groups according to whether barium was stored in the stomach during the preoperative fluoroscopic examination. Clinicopathological features, LBM 1 month after gastrectomy, and predictors of postoperative LBM loss were compared between the groups using multivariable logistic regression.
RESULTS
The incidence of >5% LBM loss and >7.5% body weight loss 1 month postoperatively were significantly higher in the storage group than in the outflow group (p=0.003 and p=0.009, respectively). Multivariable analysis revealed that gastric shape [odds ratio (OR)=3.30, 95% confidence interval (CI)=1.95-5.59, p<0.001], male sex (OR=3.20, 95% CI=2.07-4.96, p<0.001), and Roux-en-Y reconstruction (OR=1.69, 95% CI=1.08-2.64, p=0.02) were independent predictors of LBM loss. Postoperative dietary problems, especially dumping syndrome, diarrhea, and reflux were more common in the storage group (p<0.001).
CONCLUSION
Gastric shape may be a useful independent predictor of postoperative LBM loss in patients with gastric cancer undergoing distal gastrectomy.
Topics: Humans; Male; Stomach Neoplasms; Gastroenterostomy; Gastrectomy; Body Composition; Postoperative Complications; Treatment Outcome; Retrospective Studies
PubMed: 38148040
DOI: 10.21873/invivo.13458 -
Obesity Surgery Oct 2023
Salvage Surgery for Severe Post-Bariatric Hypoglycemia After Multiple Bariatric Revisions: Reversing Roux-en-Y Gastric Bypass to Sleeve with Roux Limb as Henley-Longmire Interposition.
Topics: Humans; Gastric Bypass; Obesity, Morbid; Salvage Therapy
PubMed: 37646905
DOI: 10.1007/s11695-023-06797-8 -
Cureus Jan 2024species can cause acute gastroenteritis but are much less commonly observed in the hospital setting than other bacteria. Most cases of gastroenteritis reported in the...
species can cause acute gastroenteritis but are much less commonly observed in the hospital setting than other bacteria. Most cases of gastroenteritis reported in the literature have occurred in pediatric, elderly, and/or immunocompromised patients. We present a case of subacute watery diarrhea due to infection in an otherwise healthy 48-year-old female patient with prior abdominal surgeries and recent hospitalization for a catheter-associated urinary tract infection (CAUTI) for which she received antibiotics. The patient presented with 10 days of increasingly frequent non-bloody, watery, foul-smelling diarrhea as well as decreased oral intake, cramping bilateral upper abdominal pain, chills, and malaise. Initial diagnoses considered included in the setting of CAUTI and antibiotic use, small intestinal bacterial overgrowth, dumping syndrome related to bariatric surgery, and malabsorption. A computed tomography scan of her abdomen/pelvis, admission labs, and flexible sigmoidoscopy showed no relevant findings. Stool cultures eventually returned positive for The case is an uncommon presentation of infection that could be easily missed while other diagnoses are pursued. Early treatment of infection can be crucial in preventing advanced forms of disease such as septicemia and necrotizing fasciitis.
PubMed: 38333475
DOI: 10.7759/cureus.51940 -
Internal Medicine (Tokyo, Japan) May 2024We herein report a case in which diazoxide was effective in treating reactive hypoglycemia caused by late dumping syndrome in a patient with end-stage renal disease...
We herein report a case in which diazoxide was effective in treating reactive hypoglycemia caused by late dumping syndrome in a patient with end-stage renal disease (ESRD). A 50-year-old man with ESRD and a history of gastrectomy underwent hemodialysis. Although he was administered voglibose to treat recurrent reactive hypoglycemia caused by late dumping syndrome, he had difficulty continuing treatment because of gastrointestinal side effects. When he began diazoxide treatment, the reactive hypoglycemia improved. The dose was gradually increased with no apparent side effects, and the hypoglycemic attacks disappeared one year after the start of treatment.
Topics: Humans; Diazoxide; Male; Middle Aged; Hypoglycemia; Kidney Failure, Chronic; Gastrectomy; Dumping Syndrome; Treatment Outcome; Renal Dialysis
PubMed: 37813619
DOI: 10.2169/internalmedicine.1704-23