Severe small intestinal bacterial overgrowth syndrome after jejunal feeding requiring surgical intervention: a case report and review of the literature
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...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12876-022-02370-2 |
| _version_ | 1811334574251180032 |
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| author | Majd B. Aboona Tina W. Wong Paul R. Del Prado Keith Paley Ross F. Goldberg Samuel Weimer Harikrishna Dave Dan Hobohm Adam Smith |
| author_facet | Majd B. Aboona Tina W. Wong Paul R. Del Prado Keith Paley Ross F. Goldberg Samuel Weimer Harikrishna Dave Dan Hobohm Adam Smith |
| author_sort | Majd B. Aboona |
| collection | DOAJ |
| description | 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. Case presentation 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. |
| first_indexed | 2024-04-13T17:10:58Z |
| format | Article |
| id | doaj.art-9a4b02ce3cd241099552a23a47ae3441 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-04-13T17:10:58Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-9a4b02ce3cd241099552a23a47ae34412022-12-22T02:38:17ZengBMCBMC Gastroenterology1471-230X2022-06-012211510.1186/s12876-022-02370-2Severe small intestinal bacterial overgrowth syndrome after jejunal feeding requiring surgical intervention: a case report and review of the literatureMajd B. Aboona0Tina W. Wong1Paul R. Del Prado2Keith Paley3Ross F. Goldberg4Samuel Weimer5Harikrishna Dave6Dan Hobohm7Adam Smith8University of Arizona College of MedicineDepartment of Surgery, Creighton University School of MedicineDepartment of Surgery, Valleywise Health Medical CenterDepartment of Surgery, Valleywise Health Medical CenterDepartment of Surgery, Valleywise Health Medical CenterDepartment of Surgery, Valleywise Health Medical CenterDepartment of Pathology, Valleywise Health Medical CenterDepartment of Pathology, Valleywise Health Medical CenterDepartment of Surgery, Valleywise Health Medical CenterAbstract 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. Case presentation 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.https://doi.org/10.1186/s12876-022-02370-2Small intestinal overgrowth syndromePneumatosis intestinalisPortal venous gasEnteral feedingGastric cancerGastric outlet obstruction |
| spellingShingle | Majd B. Aboona Tina W. Wong Paul R. Del Prado Keith Paley Ross F. Goldberg Samuel Weimer Harikrishna Dave Dan Hobohm Adam Smith Severe small intestinal bacterial overgrowth syndrome after jejunal feeding requiring surgical intervention: a case report and review of the literature BMC Gastroenterology Small intestinal overgrowth syndrome Pneumatosis intestinalis Portal venous gas Enteral feeding Gastric cancer Gastric outlet obstruction |
| title | Severe small intestinal bacterial overgrowth syndrome after jejunal feeding requiring surgical intervention: a case report and review of the literature |
| title_full | Severe small intestinal bacterial overgrowth syndrome after jejunal feeding requiring surgical intervention: a case report and review of the literature |
| title_fullStr | Severe small intestinal bacterial overgrowth syndrome after jejunal feeding requiring surgical intervention: a case report and review of the literature |
| title_full_unstemmed | Severe small intestinal bacterial overgrowth syndrome after jejunal feeding requiring surgical intervention: a case report and review of the literature |
| title_short | Severe small intestinal bacterial overgrowth syndrome after jejunal feeding requiring surgical intervention: a case report and review of the literature |
| title_sort | severe small intestinal bacterial overgrowth syndrome after jejunal feeding requiring surgical intervention a case report and review of the literature |
| topic | Small intestinal overgrowth syndrome Pneumatosis intestinalis Portal venous gas Enteral feeding Gastric cancer Gastric outlet obstruction |
| url | https://doi.org/10.1186/s12876-022-02370-2 |
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