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[Cholestyramine in a case of a prolonged diarrhea after a partial ileocolectomy]
Insights
A pediatric case of retrocecal appendicular abscess led to severe diarrhea and weight loss post-surgery. Cholestyramine effectively treated the malabsorption, restoring the patient's weight and health.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Case Study
Background:
- A 10-year-old female presented with a retrocecal appendicular abscess.
- The abscess led to necrosis of the terminal ileum and right colon, necessitating a partial ileocolectomy.
Observation:
- Post-operative diarrhea and significant weight loss (6 kg in 2 months) were observed.
- Initial treatments with antacids and diphenoxylate were ineffective.
- A low-fat diet resulted in partial weight recovery but persistent diarrhea with high fat excretion.
Findings:
- Cholestyramine administration, alongside a normal diet, rapidly resolved the diarrhea within 48 hours.
- The patient regained lost weight over the subsequent 3 months.
- Long-term management involves low-dose cholestyramine and a regular diet.
Implications:
- This case highlights a rare complication of appendicular abscess involving extensive bowel necrosis.
- It demonstrates the efficacy of cholestyramine in managing post-surgical fat malabsorption secondary to extensive bowel resection.
- Early diagnosis and targeted treatment are crucial for favorable outcomes in pediatric surgical complications.
Abstract:
The author reports the case of a 10 years old female child with history of retrocecal appendicular abscess complicated with terminal ileum and right colon necroses which called for partial ileocoletomy. Following this operation, the patient presented diarrhea which caused a loss in weight of 6 kgs. in two months. Antiacids and diphenoxylate were given with negative results. A low fat diet was then given and the patient recovered 1 kg. in weight, but the diarrhea persisted with high excretion of fats. Thereupon, cholestyramine and a normal diet were given followed, within the next 48 hours, by a remission of the diarrhea; the weight loss was recovered within the next 3 months. At present, the patient is still taking very small doses of cholestyramine with a normal diet.