Case report: Candidiasis of gastrojejunostomosis after pancreaticoduodenectomy: Preliminary experience from two cases
IntroductionInvasive Candida infection, or candidiasis, especially in gastrointestinal tract (GIT) is an infrequent but aggressive disease caused by Candida species. Candidiasis of gastrojejunostomosis after extensive gastrointestinal surgery may cause serious complications such as perforative perit...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.888927/full |
| _version_ | 1798039137010319360 |
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| author | Thanh Khiem Nguyen Ham Hoi Nguyen Cong Long Nguyen Cong Long Nguyen Tuan Hiep Luong Long Doan Dinh Van Duy Le Kim Khue Dang Thi Lan Tran |
| author_facet | Thanh Khiem Nguyen Ham Hoi Nguyen Cong Long Nguyen Cong Long Nguyen Tuan Hiep Luong Long Doan Dinh Van Duy Le Kim Khue Dang Thi Lan Tran |
| author_sort | Thanh Khiem Nguyen |
| collection | DOAJ |
| description | IntroductionInvasive Candida infection, or candidiasis, especially in gastrointestinal tract (GIT) is an infrequent but aggressive disease caused by Candida species. Candidiasis of gastrojejunostomosis after extensive gastrointestinal surgery may cause serious complications such as perforative peritonitis and anastomotic stenosis, which requires surgical interventions.Case presentationOur two patients had undergone pancreaticoduodenectomy (PD), respectively, due to pancreatic ductal adenocarcinoma and intraductal papillary mucinous neoplasms of the pancreatic head. Both the patients were malnutritioned and debilitated before the surgery, and they required reoperation for postoperative Candidiasis-relevant complication.In the first case, the patient was readmitted to the hospital with symptoms of perforative peritonitis, for which he underwent surgery and had Candida found in both gastrojejunostomosis ulcer and peritoneal fluid. In our second case, the patient was admitted to the hospital twice after the first operation and diagnosed with Candida-induced gastrojejunostomosis stenosis by esophagogastroduodenoscopy (EGD) and endoscopic biopsy. Fluconazole was indicated for a 2-week regimen. Blood sample withdrawn afterward showed no evidence of fungal agents, and the anastomotic stenosis responded well to treatment. However, after 3 weeks, he came back with cachexia and symptoms of gastrojejunostomotic stenosis. EGD showed no image of fungal agents but anastomotic stenosis due to chronic inflammatory process. The patient was then reoperated to redo his gastrojejunostomosis.ConclusionCandidiasis of gastrojejunostomosis after extensive gastrointestinal surgery such as PD is a very aggressive condition that may cause perforative peritonitis and anastomotic stenosis. However, there have been no publications on this disorder, and the strategic treatment remains unknown. We hereby present a report of two cases with postoperative gastrojejunostomosis candidiasis presenting with non-specific but aggressive and early clinical symptoms. |
| first_indexed | 2024-04-11T21:49:45Z |
| format | Article |
| id | doaj.art-c5ac8a27512149348bdc15d77baba566 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T21:49:45Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-c5ac8a27512149348bdc15d77baba5662022-12-22T04:01:16ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-08-011210.3389/fonc.2022.888927888927Case report: Candidiasis of gastrojejunostomosis after pancreaticoduodenectomy: Preliminary experience from two casesThanh Khiem Nguyen0Ham Hoi Nguyen1Cong Long Nguyen2Cong Long Nguyen3Tuan Hiep Luong4Long Doan Dinh5Van Duy Le6Kim Khue Dang7Thi Lan Tran8Department of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, VietnamDepartment of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, VietnamDepartment of Gastroenterology and Hepatology, Bach Mai Hospital, Hanoi, VietnamUniversity of Medicine and Pharmacy, Vietnam National University, Hanoi, VietnamDepartment of Surgery, Hanoi Medical University, Hanoi, VietnamUniversity of Medicine and Pharmacy, Vietnam National University, Hanoi, VietnamDepartment of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, VietnamDepartment of Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Bach Mai Hospital, Hanoi, VietnamPathology Center, Bach Mai Hospital, Hanoi, VietnamIntroductionInvasive Candida infection, or candidiasis, especially in gastrointestinal tract (GIT) is an infrequent but aggressive disease caused by Candida species. Candidiasis of gastrojejunostomosis after extensive gastrointestinal surgery may cause serious complications such as perforative peritonitis and anastomotic stenosis, which requires surgical interventions.Case presentationOur two patients had undergone pancreaticoduodenectomy (PD), respectively, due to pancreatic ductal adenocarcinoma and intraductal papillary mucinous neoplasms of the pancreatic head. Both the patients were malnutritioned and debilitated before the surgery, and they required reoperation for postoperative Candidiasis-relevant complication.In the first case, the patient was readmitted to the hospital with symptoms of perforative peritonitis, for which he underwent surgery and had Candida found in both gastrojejunostomosis ulcer and peritoneal fluid. In our second case, the patient was admitted to the hospital twice after the first operation and diagnosed with Candida-induced gastrojejunostomosis stenosis by esophagogastroduodenoscopy (EGD) and endoscopic biopsy. Fluconazole was indicated for a 2-week regimen. Blood sample withdrawn afterward showed no evidence of fungal agents, and the anastomotic stenosis responded well to treatment. However, after 3 weeks, he came back with cachexia and symptoms of gastrojejunostomotic stenosis. EGD showed no image of fungal agents but anastomotic stenosis due to chronic inflammatory process. The patient was then reoperated to redo his gastrojejunostomosis.ConclusionCandidiasis of gastrojejunostomosis after extensive gastrointestinal surgery such as PD is a very aggressive condition that may cause perforative peritonitis and anastomotic stenosis. However, there have been no publications on this disorder, and the strategic treatment remains unknown. We hereby present a report of two cases with postoperative gastrojejunostomosis candidiasis presenting with non-specific but aggressive and early clinical symptoms.https://www.frontiersin.org/articles/10.3389/fonc.2022.888927/fullcandidiasispancreaticoduodenectomycase reportpancreactic cancergastrojejunostomosis |
| spellingShingle | Thanh Khiem Nguyen Ham Hoi Nguyen Cong Long Nguyen Cong Long Nguyen Tuan Hiep Luong Long Doan Dinh Van Duy Le Kim Khue Dang Thi Lan Tran Case report: Candidiasis of gastrojejunostomosis after pancreaticoduodenectomy: Preliminary experience from two cases Frontiers in Oncology candidiasis pancreaticoduodenectomy case report pancreactic cancer gastrojejunostomosis |
| title | Case report: Candidiasis of gastrojejunostomosis after pancreaticoduodenectomy: Preliminary experience from two cases |
| title_full | Case report: Candidiasis of gastrojejunostomosis after pancreaticoduodenectomy: Preliminary experience from two cases |
| title_fullStr | Case report: Candidiasis of gastrojejunostomosis after pancreaticoduodenectomy: Preliminary experience from two cases |
| title_full_unstemmed | Case report: Candidiasis of gastrojejunostomosis after pancreaticoduodenectomy: Preliminary experience from two cases |
| title_short | Case report: Candidiasis of gastrojejunostomosis after pancreaticoduodenectomy: Preliminary experience from two cases |
| title_sort | case report candidiasis of gastrojejunostomosis after pancreaticoduodenectomy preliminary experience from two cases |
| topic | candidiasis pancreaticoduodenectomy case report pancreactic cancer gastrojejunostomosis |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.888927/full |
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