A case of fulminant <i>clostridium difficile </i>colitis cured by total colectomy

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  • TAKETA Takashi
    Department of Gastroenterological Surgery, St. Luke's International Hospital
  • OHIGASHI Seiji
    Department of Gastroenterological Surgery, St. Luke's International Hospital
  • SHIOZAKI Hironori
    Department of Gastroenterological Surgery, St. Luke's International Hospital
  • SUDO Kazuki
    Department of Gastroenterological Surgery, St. Luke's International Hospital
  • ONODERA Hisashi
    Department of Gastroenterological Surgery, St. Luke's International Hospital

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  • 劇症型<I>Clostridium difficile</I>腸炎に対して結腸全摘術を施行し救命した1例
  • A CASE OF FULMINANT CLOSTRIDIUM DIFFICILE COLITIS CURED BY TOTAL COLECTOMY

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We report a patient with fulminant Clostridium difficile colitis who was successfully treated by emergency total colectomy. A 78-year-old woman, who underwent a partial colectomy for colon cancer two weeks prior, developed abdominal distension without diarrhea. Abdominal CT showed diffuse thickening and dilatation of the entire colon, which is the typical in toxic megacolon. A colonoscopy revealed severe pseudo-membranous formation of the entire colon ; a positive assay for Clostridium difficile toxin in her stool was reported. A diagnosis of fulminant Clostridium difficile colitis was made, and intravenous metronidazole treatment was initiated. However as the patient's general condition was deteriorating rapidly despite antibacterial therapy, an emergency total colectomy with ileostomy was done on the 4th hospital day. The patient quickly recovered after the operation and was discharged on the 28th postoperative day. It is important to know that surgical treatment is the only effective modality for some fulminant Clostridium difficile colitis patients.

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