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A Case of Pyoderma Gangrenosum after Partial Small Bowel Resection
Jianing Wang1, Shiyao Jiang, Xin Shi
1In the Department of Dermatology, the Second Affiliated Hospital of Soochow University, Suzhou, China, Jianing Wang, MD, and Shiyao Jiang, MD, are Residents; Xin Shi, BS, is Chief Physician; and Wenlin Li, MD, and Qianchun Yu, MD are also Residents. In the Department of Dermatology, Suzhou Municipal Hospital, Ting Pan, MD, and Yuzhu Mu, MD, are Residents; and Lingling Chen, MD, is Chief Physician.
Abstract:
Pyoderma gangrenosum (PG) is a rare, noninfectious inflammatory disease of unknown etiology that affects the skin and mucous membranes. The development of PG after partial small bowel resection is very rare and can initially resemble an infectious complication, although it is an inflammatory disease.This report presents the case of a 55-year-old man who underwent partial small bowel resection for incomplete intestinal obstruction and developed postoperative infection-like manifestations, including redness and swelling of the incision, severe pain, and yellow-green turbid fluid from the drainage tube. After completing a skin biopsy that suggested massive neutrophil infiltration, multiple secretion cultures for Pseudomonas aeruginosa (+), and systemic screening without other comorbidities, a diagnosis of postoperative PG and P aeruginosa infection was determined.Early detection of this complication is essential for patient recovery because primary surgical treatment, which is contraindicated in such cases, can worsen PG. Therefore, PG should be treated conservatively with corticosteroids.
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