RESUMEN
We report a case of pseudomembranous colitis that developed in a patient with liver cirrhosis during anti-tuberculosis therapy with rifampicin and isoniazid. The association between rifampicin and pseudomembranous colitis has been controversial; this report, however, supports the association. Colonoscopy performed 3 days after the onset of the pseudomembranous colitis revealed only reddish patches and a few aphthoid lesions, but 4 days later pseudomembranes were apparent. The pseudomembranous colitis was successfully controlled by discontinuation of the anti-tuberculosis agents, along with the administration of lactic acid bacteria, without vancomycin or metronidazole. Possible predisposing factors for the development of pseudomembranous colitis in this patient are also discussed.
Asunto(s)
Antibióticos Antituberculosos/efectos adversos , Enterocolitis Necrotizante/inducido químicamente , Rifampin/efectos adversos , Tuberculosis Pulmonar/tratamiento farmacológico , Antibióticos Antituberculosos/uso terapéutico , Biopsia , Colonoscopía , Enterocolitis Necrotizante/diagnóstico , Enterocolitis Necrotizante/patología , Femenino , Humanos , Mucosa Intestinal/efectos de los fármacos , Mucosa Intestinal/patología , Persona de Mediana Edad , Rifampin/uso terapéutico , Factores de RiesgoRESUMEN
To study the motility functions after transection and anastomosis of the intestinal tract, the interdigestive action potential was induced experimentally and observed in the small intestines of conscious fasted dogs. When the intestinal tract was transected, the frequency gradient of the basic electric rhythm was disturbed even in cases of subsequent anastomosis. Differences arose in the frequency as upper and lower part of anastomosis, and it did not return to normal. The spike potential which appeared with the building up of the basic electric rhythm was propagated to the distal intestine in a normal course after transection of the intestinal tract according to observations centered on propagation of the IMEC. The propagation velocity of the IMEC gradually drops from the proximal jejunum toward the terminal ileum in the nonmanipulated intestine, while in the intestine undergoing transection and anastomosis, the velocity of propagation was reduced by half in the area of anastomosis, and tended to be even lower in cases of a double section and two anastomoses of the distal intestine. However, the total elapsed time in the small intestine was not extended by much. A new electric complex appeared from the stump of the distal intestine when the intestine was subjected to transection, and a stimulation which is involved in the appearance of the spike potential was formed.