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Fig. 1 | BMC Gastroenterology

Fig. 1

From: Small intestinal bacterial overgrowth as a cause of protracted wound healing and vitamin D deficiency in a spinal cord injured patient with a sacral pressure sore: a case report

Fig. 1

Patient images. a, b, c, and d Sacral pressure sore. a Day 0: sore 10.0 × 6.5 cm in size with an entrance of 6.0 × 3.5 cm; DESIGN-R score was D3 e3 s8 i0 g3 N3 P24 with a total score of 44. b Day 405 (i.e., 285 days after starting SDD for treating SIBO): reduced size of sore; DESIGN-R score was D3 e3 s3 i0 g1 n0 p0 with a total score of 10. c Day 742 (i.e., 617 days after staring SDD): healed sore; DESIGN-R score was d0 e0 s0 i0 g0 n0 p0 with a total score of 0. d Day 1057 (i.e., 932 days after staring SDD): no recurrence of the sore. e and f Osteoporosis and multiple fractures. e X-ray showing left tibial fracture. f Tc-99 m bone scan showing accumulation in multiple ribs, vertebrae, and right ulna. g, h, and i Endoscopic examination and results of bacterial culture of the upper digestive tract. All stomach, duodenum, and proximal jejunum samples were positive for E. coli. g Stomach. Food residue can be seen. Acid level was decreased to pH 7.0. h Duodenum. Food residue is evident. i Proximal jejunum. Flat villi and a jejunal ulcer are observed

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