title: A case of colonic pseudoobstruction related to bacterial overgrowth due to a sigmoidocecal fistula.
abstract: Colocolic fistulas are usually a complication of an inflammatory or neoplastic process. Development of these abnormal bowel communications may lead to bacterial overgrowth. We report on a 71-year-old man with a one-year history of recurrent abdominal distension and irregular bowel habits. Abdominal X-rays and computed tomography showed multiple air-fluid levels and loops of distended bowel without evidence of mechanical obstruction or diverticulitis. Colonoscopy showed a fistulous tract between the sigmoid colon and cecum. Results of a lactulose breath test showed high fasting breath CH4 levels, which were thought to be the result of intestinal bacterial overgrowth. The patient was diagnosed with a colonic pseudo-obstruction associated with bacterial overgrowth due to a sigmoidocecal fistula. We recommended surgical correction of the sigmoidocecal fistula; however, the patient requested medical treatment. After antibiotic therapy, the patient still had mild symptoms but no acute exacerbations.
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, 42, Jebong-ro, Dong-gu, Gwang-ju 501-757, Korea.
authors.forename: Kyoung Myeun
authors.initials: KM
authors.lastname: Chung
authors.forename: Seong Uk
authors.initials: SU
authors.lastname: Lim
authors.forename: Hyoung Ju
authors.initials: HJ
authors.lastname: Hong
authors.forename: Seon Young
authors.initials: SY
authors.lastname: Park
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Park
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Choi
authors.forename: Jong Sun
authors.initials: JS
authors.lastname: Rew
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001944:Breath Tests; D003112:Colonic Pseudo-Obstruction / Q000175:diagnosis* / Q000209:etiology; D003113:Colonoscopy; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D008697:Methane / Q000737:chemistry / Q000378:metabolism; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D008697:Methane