Appendectomy and Clostridium difficile colitis:Relationships revealed by clinical observations and immunology

作     者：Nathan L Sanders R Randal Bollinger Ryan Lee Steven Thomas William Parker 

作者机构：Department of SurgeryDuke University Medical Center 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第34期

页      面：5607-5614页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Appendectomy Clostridium difficile Colitis Diarrheal illness Vermiform appendix 

摘      要：Advances in understanding the interaction between the human immune system and the microbiome have led to an improved understanding of the function of the vermiform appendix as a safe-house for beneficial bacteria in the *** advances have been made despite long standing clinical observations that the appendectomy is a safe and effective ***,more recent clinical data show that an appendectomy puts patients at increased risk for recurrent Clostridium difficile(***)-associated colitis,and probably other diseases associated with an altered *** the same time,appendectomy does not apparently put patients at risk for an initial onset of ***-associated *** clinical observations point toward the idea that the vermiform appendix might not effectively protect the microbiome in the face of broad spectrum antibiotics,the use of which precedes the initial onset of ***-associated ***,these observations point to the idea that historically important threats to the microbiome such as infectious gastrointestinal pathogens have been supplanted by other threats,particularly the use of broad spectrum antibiotics.